Left Atrium Maximal Axial Cross-Sectional Area is a Specific Computed Tomographic Imaging Biomarker of World Health Organization Group 2 Pulmonary Hypertension
- 1 March 2017
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Thoracic Imaging
- Vol. 32 (2), 121-126
- https://doi.org/10.1097/rti.0000000000000252
Abstract
Purpose: Left heart disease is associated with left atrial enlargement and is a common cause of pulmonary hypertension (PH). We investigated the relationship between left atrium maximal axial cross-sectional area (LA-MACSA), as measured on chest computed tomography (CT), and PH due to left heart disease (World Health Organization group 2) in patients with right heart catheterization–proven PH. Materials and Methods: A total of 165 patients with PH who had undergone right heart catheterization with pulmonary artery pressure and pulmonary capillary wedge pressure (PCWP) measurements and nongated chest CTs were included. LA-MACSA, LA anterior-posterior, and LA transverse measurements were independently obtained using the hand-drawn region-of-interest and distance measurement tools on standard PACS by 2 blinded cardiothoracic radiologists. Nonparametric statistical analyses and receiver operating characteristic curve were performed. Results: Forty-three patients had group 2 PH (PCWP>15 mm Hg), and 122 had nongroup 2 PH (PCWP≤15 mm Hg). Median LA-MACSA was significantly different between the group 2 PH and nongroup 2 PH patients (2312 vs. 1762 mm2, PP2, LA-MACSA demonstrated 93% specificity for classifying group 2 PH (area under the curve, 0.73; P<0.001). Conclusions: LA-MACSA is a readily obtainable and reproducible measurement of left atrial enlargement on CT and can distinguish between group 2 and nongroup 2 PH with high specificity.Keywords
This publication has 16 references indexed in Scilit:
- Evolving Concepts of Pulmonary Hypertension Secondary to Left Heart DiseaseCurrent Heart Failure Reports, 2016
- Pulmonary arterial hypertension or left heart disease with pulmonary hypertension? Toward noninvasive clarity, but time for a new paradigm.European Respiratory Journal, 2015
- Updated Clinical Classification of Pulmonary HypertensionJournal of the American College of Cardiology, 2013
- Pulmonary Artery Measurements in Pulmonary HypertensionJournal of Thoracic Imaging, 2013
- Pulmonary Arterial Enlargement and Acute Exacerbations of COPDThe New England Journal of Medicine, 2012
- Detection of Pulmonary Hypertension with Multidetector CT and Echocardiography Alone and in CombinationRadiology, 2010
- Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta‐analysis of longitudinal data (MeRGE Heart Failure)European Journal of Heart Failure, 2009
- Heart failure with preserved left ventricular systolic function: epidemiology, clinical characteristics, and prognosisJournal of the American College of Cardiology, 2004
- Utility of CT Scan Evaluation for Predicting Pulmonary Hypertension in Patients With Parenchymal Lung DiseaseSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1998
- Left Atrial Size and the Risk of Stroke and DeathCirculation, 1995