In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
Abstract:
Introduction: The in vivo relationship between small pulmonary vessels (SPV) and pulmonary hypertension (PH) and its association with pulmonary function and prognosis in PH is not fully understood. Hypothesis: The morphological change in SPV volumes (SPVV) can be quantitatively estimated from CT pulmonary angiography (CTPA) in different subtypes of PH and is associated with pulmonary function metrics and prognosis in PH. Methods: : In this retrospective single center study performed from January 2008 to February 2018, quantitative CTPA analysis of total SPVV (TSPVV) (0.4-2mm vessel diameter) was performed using VIDA Diagnostics software (LungPrintTM, VIDA Diagnostics, Inc., Coralville, IA, USA). Results: 1823 patients (mean (SD) age 69 (13) years, 65% females) were analysed. 1593 patients with PH (mPAP = 43 (13) mmHg) were compared to 230 patient controls (mPAP=20 (3) mmHg). Mean small vessel volumes at a diameter below 2 mm were lower in PAH and PH associated with left heart disease compared to controls (-4.3 (-8 to -0.1) ml for 1.6 mm vessels, p=.03 and -6.8 (-11 to -2) ml, p 〈 .001, respectively). In patients with PH, the most significant positive correlation was noted with FVC%predicted (r=0.30-0.40, all p 〈 .001). Median survival for TSPVV≤1.2mm greater than 50 ml was longer than TSPVV≤1.2mm less than or equal 50 ml (85 versus 71 months, 95% C.I 73-97, p=.02, respectively). Median survival for TSPVV 〉 1.2mm greater than 135 ml was longer than TSPVV 〉 1.2mm less than or equal 135 ml (88 versus 72 months, 95% C.I 73-98, p=.02, respectively). TSPVV≤1.2mm greater than 50 ml (HR 0.851, p=.02) and TSPVV 〉 1.2mm greater than 135 ml (HR 0.839, p=.02) were significant predictors of mortality on univariate analysis. TSPVV≤1.2mm greater than 50 ml (HR 0.785, p=.04) was independent predictor of mortality on multivariate analysis in addition to age, Male gender, mRAP, PVR and SvO2. Conclusions: The morphological change in small vessels can be successfully quantified from CTPA in different subtypes of PH and is associated with pulmonary function metrics and prognosis in PH.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.146.suppl_1.14089
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
1466401-X
detail.hit.zdb_id:
80099-5
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