Work

Noninvasive assessment of pulmonary vascular resistance: a synergistic approach using computed tomography pulmonary angiography and echocardiography in pulmonary hypertension

Year: 2025

Type: article

Abstract: Background: Pulmonary vascular resistance (PVR) is essential in managing pulmonary hypertension (PH) and has prompted the search for noninvasive assessment techniques. This study investigates the integration of morphological parameters from computed tomography pulmonary angiography (CTPA) and functional parameters from transthoracic echocardiography (TTE) to develop a noninvasive method for evaluating PVR in patients with PH. Methods: Data from PH patients who underwent CTPA, TTE, and right heart catheterization (RHC) were analyzed retrospectively. The Cobb angle, defined as the angle between the spine and interventricular septum, was calculated by CTPA. It is assumed that thorax geometry, pericardial morphology, and body surface area (BSA) are factors influencing the Cobb angle measurement, and these factors were adjusted for in the analysis. Multiple linear regression was performed to evaluate the multivariate ability to predict PVR. Multivariate Cox regression analysis assessed the prognostic value of parameters in predicting hospitalization for heart failure. Results: =0.634, P<0.001) and was effective across different demographics. After multivariable adjustment, the Cobb angle [hazard ratio (HR): 1.057; P<0.001], Cobb angle/BSA (HR: 1.087; P<0.001), tricuspid annular plane systolic excursion (TAPSE) (HR: 0.878; P=0.014), RVOT-AT (HR: 0.968; P=0.030), and right ventricular myocardial performance index (RVMPI) (HR: 5.324; P<0.001) remained significant independent predictors of heart failure. Conclusions: The integration of BSA-adjusted morphological markers from CTPA with hemodynamic parameters derived from TTE provides a promising noninvasive method for predicting PVR and demonstrates significant prognostic value in evaluating heart failure in PH patients.

Source: Quantitative Imaging in Medicine and Surgery

DOI: 10.21037/qims-24-2152

Authors: Junqing Ma, Wenting Li, Sunan Xu, Ruichen Ren, Xiaopei Cui, Yongze Zheng, Yan Deng, Yongfeng Liang, Yang Zhang

Institutions: Shandong University, Nanjing General Hospital of Nanjing Military Command, Qilu Hospital of Shandong University, Nanjing University

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: diamond

OpenAlex ID: W4413369221

FWCI:

Cites: 1

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Related to: 10