Diagnostic accuracy of echocardiography combined with chest CT in pulmonary hypertension. (3rd February 2017)

• Record Type: Journal Article
• Authors: Shujaat, Adil; Bajwa, Abubakr A.; Al‐Saffar, Farah; Bellardini, Jason; Jones, Lisa; Cury, James D.
• Is Part Of: Clinical respiratory journal. Volume 12:Number 3(2018)
• Page Start: 948
• Page End: 952
• Publication Date: 2017-02-03
• Subjects: chest CT -- diagnosis -- echocardiography -- pulmonary hypertension; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12610
• Languages: English
• ISSNs: 1752-6981

Abstract

Abstract: Background: Transthoracic echocardiography (TTE) and computerized axial tomography (CT) are complementary imaging techniques. It is possible that a combination of the two may offer a better way of identifying pulmonary hypertension (PH) than either one alone. Objectives: To determine the diagnostic accuracy of TTE combined with chest CT in pulmonary hypertension. Methods: We performed a retrospective review of consecutive patients who had undergone TTE, CT and right heart catheterization (RHC) between 7/1/2008 and 6/30/2012. PH was defined as systolic pulmonary artery pressure >40 mm Hg or tricuspid regurgitant (TR) jet velocity >2.8m/s on TTE, ratio of diameter of pulmonary artery to ascending aorta (rPA) >1 or diameter of PA (dPA) >30 mm on CT, and mean PAP (mPAP) >25 mm Hg on RHC. Results: There was a total of 87 patients. The mean ± SD age was 54.3 ± 15.9 years and 69 (79%) were female. The prevalence of PH was 75%. The mean ± SD mPAP was 35.8 ± 14.2 mm Hg. The majority of the patients belonged to World Health Organization group I PH. Fifty per cent of the CT scans were done with intravenous contrast dye. The combination of TR jet velocity and rPA provided the best combination of sensitivity (98%) and specificity (70%) with an ROC area under the curve of 0.84. Conclusion: The combination of TTE and chest CT is better than either imaging technique alone in identifying patients with PH in a heterogeneous population and may exclude PH