Abstract
Background: Currently, patients with COPD who are evaluated for bronchoscopic treatments are routinely screened for pulmonary hypertension (PH) and systolic left ventricle dysfunction by echocardiography. Objectives: We evaluated the prevalence of PH and systolic left ventricle dysfunction in this patient group and investigated if the previously proposed CT-derived pulmonary artery to aorta (PA:A) ratio >1 and PA diameter measurements can be used as alternative screening tools for PH. Methods: Two hundred fifty-five patients were included in this retrospective analysis (FEV1 25%pred, RV 237%pred). All patients received transthoracic echocardiography and chest CT scans on which diameters of the aorta and pulmonary artery were measured at the bifurcation and proximal to the bifurcation. Results: Following echocardiography, 3 patients (1.2%) had PH and 1 (0.4%) had systolic left ventricle dysfunction. Using a PA:A ratio >1, only 10.3% of the patients with a right ventricular systolic pressure (RVSP) >= 35 mm Hg were detected and none of the patients with an RVSP >50 mm Hg were detected. Patients with an RVSP >= 35 mm Hg had significantly higher PA diameters (29.5 vs. 27.5 mm; p = 0.02) but no significantly different PA:A ratios. All patients with an RVSP >50 mm Hg had PA diameters >30 mm. Conclusions: The prevalence of PH and systolic left ventricle dysfunction is low in this preselected cohort of patients with severe COPD. In this population, a PA:A ratio >1 is not a useful cardiac screening tool for PH. A PA diameter >30 mm could substitute for routinely performed echocardiography in the screening for PH in this patient group.
Original language | English |
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Pages (from-to) | 1-7 |
Number of pages | 7 |
Journal | Respiration |
Issue number | 10 |
Early online date | 2-Dec-2020 |
DOIs | |
Publication status | Published - 2-Dec-2020 |
Keywords
- Interventional pulmonology
- COPD
- Emphysema
- Pulmonary hypertension
- Computed tomography
- LUNG-VOLUME-REDUCTION
- EXPERT PANEL
- HYPERTENSION
- SURGERY