Work

CT imaging biomarkers to predict severity and prognosis of pulmonary hypertension

Year: 2025

Type: article

Abstract: PURPOSE: To explore whether there are computed tomography (CT) imaging biomarkers that can stratify the severity of patients with pulmonary hypertension (PH). METHODS: We retrospectively enrolled 144 consecutive patients with suspected PH who underwent CT pulmonary angiography and right heart catheterization (RHC). CT findings were analyzed by two observers for large vessel size [ascending aorta (A), pulmonary artery (P), inferior vena cava (IVC)], each chamber size, and septal angle. We investigated the associations between CT imaging parameters and the mean pulmonary artery pressure (mPAP) from RHC. During a median follow-up of 36 months, we observed major adverse cardiovascular events (MACE; all-cause mortality and hospitalization for PH worsening). Univariate and multivariate Cox regression models were used with hazard ratios (HR) and 95% confidence intervals (95% CI) to determine independent predictors of MACE in patients with PH. RESULTS: Of 144 patients, 116 (80.2%) were diagnosed with PH based on an mPAP of 20 mmHg. Among CT parameters, P, P/A ratio, right ventricle (RV), and RV/left ventricle (LV) ratio were strongly correlated with mPAP values (Pearson's correlation coefficient, all r < 0.001). During the follow-up period, 44 (30.6%) patients developed MACE (14 deaths and 30 hospitalizations). Using multivariate Cox regression analysis, the RV/LV ratio (HR 2.32; 95% CI: 1.17-4.59) was the best predictor of MACE, followed by age (HR 1.03, 95% CI;1.00-1.05) (all p < 0.05). Among various CT parameters, A, P, and P/A ratio showed excellent reliability with intraclass correlation coefficient ≥ 0.95. CONCLUSION: Among CT parameters, the RV/LV ratio was the most robust predictor of MACE in patients with PH, while the P and P/A ratios served as reliable indicators reflecting mPAP levels.

Source: PLoS ONE

DOI: 10.1371/journal.pone.0313235

Authors: Do won Yoon, Yeonyee E. Yoon, In Chang Hwang, Wonjae Lee, Ki-Yeal Lee, Eun Ju Chun

Institutions: Seoul National University, Seoul National University Bundang Hospital, Korea University, Korea University Medical Center

Language: English

Topic: Pulmonary Hypertension Research and Treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,382