Skip Navigation LinksHome > March/April 2014 - Volume 38 - Issue 2 > Relationship of Main Pulmonary Artery Diameter to Pulmonary...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182aa7fc5
Cardiovascular & Thoracic Imaging

Relationship of Main Pulmonary Artery Diameter to Pulmonary Arterial Pressure in Scleroderma Patients With and Without Interstitial Fibrosis

McCall, Robert K. MD, MSCR*; Ravenel, James G. MD; Nietert, Paul J. PhD; Granath, Aleksandra MD, PhD*; Silver, Richard M. MD*

Collapse Box

Abstract

Objective

This study aimed to determine the relationship between main pulmonary artery diameter (MPAD) and pulmonary hypertension (PH) in scleroderma patients with and without interstitial lung disease.

Methods

We retrospectively reviewed 48 subjects with scleroderma who underwent a chest computed tomography (CT) and right heart catheterization with 6 months of each other. Patients were divided into 2 groups based on the absence or presence of interstitial lung disease on chest CT. Subset analysis was performed based on available pulmonary function tests and divided into groups by forced vital capacity (FVC). Computed tomographic scans were scored for extent of fibrosis and ground glass opacity. Pulmonary artery and ascending aorta measurements were obtained by 2 independent observers. Univariate and multivariate models were used to evaluate the correlation between MPAD and mean pulmonary artery pressure (mPAP) measured by right heart catheterization. Receiver operating characteristic analysis was performed for diagnostic accuracy of the MPAD measurement in predicting PH.

Results

Strong correlations between mPAP and MPAD were found in this study regardless of the presence or absence of mild to moderate interstitial fibrosis on chest CT. When dividing patients based on FVC, the correlation between mPAP and MPAD was substantially attenuated. An MPAD value of 30.8 mm yielded the highest sensitivity and specificity at 81.3% and 87.5%, respectively.

Conclusions

In scleroderma patients, an enlarged main pulmonary artery (>30 mm) predicts PH even in the presence of mild to moderate fibrosis although the relationship may be attenuated in the presence of a low % FVC.

Copyright © 2014 by Lippincott Williams & Wilkins

  

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.