Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD

Firdaus A. Mohamed Hoesein; Tim Besselink; Esther Pompe; Erik Jan Oudijk; Ed A van de Graaf; J. M. Kwakkel-van Erp; Pim A. de Jong; Bart Luijk

doi:10.1007/s00408-016-9926-8

Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD

Firdaus A. Mohamed Hoesein^*, Tim Besselink, Esther Pompe, Erik Jan Oudijk, Ed A van de Graaf, J. M. Kwakkel-van Erp, Pim A. de Jong, Bart Luijk

^*Corresponding author for this work

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Abstract

INTRODUCTION: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD.

METHODS: COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.

RESULTS: Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24).

CONCLUSION: A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.

Original language	English
Pages (from-to)	813-819
Number of pages	7
Journal	Lung
Volume	194
Issue number	5
DOIs	https://doi.org/10.1007/s00408-016-9926-8
Publication status	Published - 1 Oct 2016

Keywords

COPD
Pulmonary circulation and pulmonary hypertension
Radiology and other imaging

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title = "Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD",

abstract = "INTRODUCTION: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD.METHODS: COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.RESULTS: Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24).CONCLUSION: A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.",

keywords = "COPD, Pulmonary circulation and pulmonary hypertension, Radiology and other imaging",

author = "{Mohamed Hoesein}, {Firdaus A.} and Tim Besselink and Esther Pompe and Oudijk, {Erik Jan} and {van de Graaf}, {Ed A} and {Kwakkel-van Erp}, {J. M.} and {de Jong}, {Pim A.} and Bart Luijk",

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T1 - Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD

AU - Mohamed Hoesein, Firdaus A.

AU - Besselink, Tim

AU - Pompe, Esther

AU - Oudijk, Erik Jan

AU - van de Graaf, Ed A

AU - Kwakkel-van Erp, J. M.

AU - de Jong, Pim A.

AU - Luijk, Bart

PY - 2016/10/1

Y1 - 2016/10/1

N2 - INTRODUCTION: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD.METHODS: COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.RESULTS: Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24).CONCLUSION: A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.

AB - INTRODUCTION: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD.METHODS: COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated.RESULTS: Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24).CONCLUSION: A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.

KW - COPD

KW - Pulmonary circulation and pulmonary hypertension

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JF - Lung

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ER -

Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD

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