AI Article Synopsis
- Chronic thromboembolic pulmonary hypertension (CTEPH) can occur when acute pulmonary embolism does not fully resolve, and the study investigates whether changes in CT Hounsfield Unit gradient (HU-Δ) can indicate low cardiac index (CI).
- A retrospective analysis of 237 CTEPH patients revealed that higher HU-Δ values between the main pulmonary artery (MPA) and both the left atrium (LA) and left ventricle (LV) were associated with low CI, showing distinct statistical differences.
- The study found that certain HU-Δ thresholds could effectively predict low CI, demonstrating high sensitivity and reproducibility, suggesting these measurements might be useful markers in clinical
Article Abstract
Unlabelled: Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of incomplete resolution of acute pulmonary embolism. We hypothesize changes in CT Hounsfield Unit gradient (HU-Δ) created by the dispersion of IV contrast through the downstream blood pool correlate with cardiac index (CI). We sought to compare HU-Δ with invasively obtained CI.
Methods: We completed a retrospective analysis of CTEPH patients in which individuals with low CI (<2.2-L/min/m) were identified. Both absolute and fractional HU-Δ were derived from pulmonary CTA by subtracting the HU value of the left atrium (LA) and left ventricle (LV) from the main pulmonary artery (MPA) (absolute) and expressing them as a percentage of MPA-HU (fractional) on static axial images. These were compared between low and normal CI.
Results: Of the 237 patients, 50.2% were female, 53.2% were White, 36.7% were Black. Hemodynamics were mean pulmonary artery (PA) pressure = 45.4 ± 11.2-mmHg, pulmonary vascular resistance = 9.2 ± 4.4-WU, CI = 2.05 ± 0.48-L/min/m. There was a higher mean MPA-HU = 391.1 ± 113.6 than LA-HU = 251.6 ± 81. In patients with low CI, the HU-Δ was higher, HU-ΔMPA-LA was 148.9 ± 78.4 vs. 124.5 ± 77.2 ( = 0.02), and HU-ΔMPA-LV was 170.7 ± 87 vs. 140 ± 82 ( = 0.009). A HU-ΔMPA-LA = 118 had a sensitivity of 75.6% and specificity of 77% to detect low CI, AUC 0.61, = 0.003. A HU-ΔPA-LV = 156 had a sensitivity of 77% and specificity of 53% to detect low CI, AUC = 0.62, = 0.001. A fractional reduction HU-ΔMPA-LA of 35% had a sensitivity and specificity of 79% and 53%, respectively, to detect low CI (AUC 0.65, < 0.001). A fractional reduction of the HU-ΔMPA-LV of 40% had a sensitivity and specificity of 80% and 55%, respectively, to detect low CI (AUC 0.65, < 0.001). HU Δ were highly reproducible (Kappa = 0.9, < 0.001, 95% CI 0.86-0.95).
Conclusions: High HU Δ between MPA-LA and MPA-LV were associated with low CI in patients with CTEPH.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11432232 | PMC |
| http://dx.doi.org/10.3390/jcdd11090281 | DOI Listing |
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