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Clinical significance of lung cross-sectional area measured by computed tomography in chronic thromboembolic pulmonary hypertension: The correlation with pulmonary hemodynamics and the limitations.

Clinical significance of lung cross-sectional area measured by computed tomography in chronic thromboembolic pulmonary hypertension: The correlation with pulmonary hemodynamics and the limitations.

Authors :
Kuriyama A
Kasai H
Sugiura T
Nagata J
Naito A
Sekine A
Shigeta A
Sakao S
Ishida K
Matsumiya G
Tanabe N
Suzuki T
Source :
Pulmonary circulation [Pulm Circ] 2023 Sep 11; Vol. 13 (3), pp. e12287. Date of Electronic Publication: 2023 Sep 11 (Print Publication: 2023).
Publication Year :
2023

Abstract

The percentage cross-sectional area of the lung under five (%CSA <subscript><5</subscript> ) is the percentage of pulmonary vessels with <5 mm <superscript>2</superscript> area relative to the total lung area on computed tomography (CT). The extent that %CSA <subscript><5</subscript> is related to pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is unclear, as is the effect of pulmonary endarterectomy (PEA) on %CSA <subscript><5</subscript> . Therefore, we aimed to evaluate the clinical significance of %CSA <subscript><5</subscript> in patients with CTEPH. We studied 98 patients (64 females, mean age 62.5 ±â€‰11.9 years), who underwent CT with %CSA <subscript><5</subscript> measurement and right heart catheterization (RHC). Patients were classified into groups based on eligibility for PEA. We compared the %CSA <subscript><5</subscript> with pulmonary hemodynamics measured by RHC in various groups. In 38 patients who underwent PEA, the relationship between %CSA <subscript><5</subscript> and pulmonary hemodynamics was also evaluated before and after PEA. Significant correlations between %CSA <subscript><5</subscript> and pulmonary vascular resistance, and compliance, and pulmonary artery pulse pressure were observed in all patients. Pulmonary hemodynamics in the patients who underwent or were eligible for PEA showed a significant correlation with %CSA <subscript><5</subscript> . Additionally, %CSA <subscript><5</subscript> was significantly lower in the postoperative than in the preoperative group. There was no correlation between changes in %CSA <subscript><5</subscript> and pulmonary hemodynamics before and after PEA. Furthermore, %CSA <subscript><5</subscript> did not correlate significantly with prognosis. %CSA <subscript><5</subscript> may reflect pulmonary hemodynamics in CTEPH with central thrombosis. Furthermore, %CSA <subscript><5</subscript> was reduced by PEA postoperatively. However, %CSA <subscript><5</subscript> is not a prognostic indicator, its clinical usefulness in CTEPH patients is limited, and further validation is required.<br />Competing Interests: The authors declare no conflicts of interest.<br /> (© 2023 The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute.)

Details

Language :
English
ISSN :
2045-8932
Volume :
13
Issue :
3
Database :
MEDLINE
Journal :
Pulmonary circulation
Publication Type :
Academic Journal
Accession number :
37701143
Full Text :
https://doi.org/10.1002/pul2.12287