Diagnostic accuracy of CT pulmonary angiography in suspected pulmonary hypertension.
Objectives: Computed tomography (CT) pulmonary angiography is widely used in patients with suspected pulmonary hypertension (PH). However, the diagnostic and prognostic significance remains unclear. The aim of this study was to (a) build a diagnostic CT model and (b) test its prognostic significance...
| Publicado en: | European Radiology Vol. 30; no. 9; pp. 4918 - 4930 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Sep2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145263138&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145263138 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Sep2020 vid: 30 iid: 9 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 145263138 143907105 145263138 NLM32342182 145263138 10.1007/s00330-020-06846-1 NLM32342182 145263138 ppf: 4918 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Diagnostic accuracy of CT pulmonary angiography in suspected pulmonary hypertension. aug: au: Swift, Andrew J. Dwivedi, Krit Johns, Chris Garg, Pankaj Chin, Matthew Currie, Ben J Rothman, Alex MK Capener, Dave Shahin, Yousef Elliot, Charlie A Charalampopolous, Thanos Sabroe, Ian Rajaram, Smitha Hill, Catherine Wild, Jim M. Condliffe, Robin Kiely, David G. affil: Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK sug: subj: Pulmonary Wedge Pressure Physiology Hypertension, Pulmonary Diagnosis Pulmonary Artery Aged Hypertension, Pulmonary Physiopathology Male Lung Physiopathology Middle Age ROC Curve Female Pulmonary Artery Physiopathology Heart Catheterization Methods Funding Source Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Objectives: Computed tomography (CT) pulmonary angiography is widely used in patients with suspected pulmonary hypertension (PH). However, the diagnostic and prognostic significance remains unclear. The aim of this study was to (a) build a diagnostic CT model and (b) test its prognostic significance.Methods: Consecutive patients with suspected PH undergoing routine CT pulmonary angiography and right heart catheterisation (RHC) were identified. Axial and reconstructed images were used to derive CT metrics. Multivariate regression analysis was performed in the derivation cohort to identify a diagnostic CT model to predict mPAP ≥ 25 mmHg (the existing ESC guideline definition of PH) and > 20 mmHg (the new threshold proposed at the 6th World Symposium on PH). In the validation cohort, sensitivity, specificity and compromise CT thresholds were identified with receiver operating characteristic (ROC) analysis. The prognostic value of the CT model was assessed using Kaplan-Meier analysis.Results: Between 2012 and 2016, 491 patients were identified. In the derivation cohort (n = 247), a CT model was identified including pulmonary artery diameter, right ventricular outflow tract thickness, septal angle and left ventricular area. In the validation cohort (n = 244), the model was diagnostic, with an area under the ROC curve of 0.94/0.91 for mPAP ≥ 25/> 20 mmHg respectively. In the validation cohort, 93 patients died; mean follow-up was 42 months. The diagnostic thresholds for the CT model were prognostic, log rank, all p < 0.01.Discussion: In suspected PH, a diagnostic CT model had diagnostic and prognostic utility.Key Points: • Diagnostic CT models have high diagnostic accuracy in a tertiary referral population of with suspected PH. • Diagnostic CT models stratify patients by mortality in suspected PH. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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