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Linguraru MG, Pura JA, Gladwin MT, et al. Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease. Pulm Circ. 2014;4(2):319-29doi: 10.1086/675997.
Linguraru, M. G., Pura, J. A., Gladwin, M. T., Koroulakis, A. I., Minniti, C., Machado, R. F., Kato, G. J., & Wood, B. J. (2014). Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease. Pulmonary circulation, 4(2), 319-29. https://doi.org/10.1086/675997
Linguraru, Marius George, et al. "Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease." Pulmonary circulation vol. 4,2 (2014): 319-29. doi: https://doi.org/10.1086/675997
Linguraru MG, Pura JA, Gladwin MT, Koroulakis AI, Minniti C, Machado RF, Kato GJ, Wood BJ. Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease. Pulm Circ. 2014 Jun;4(2):319-29. doi: 10.1086/675997. PMID: 25006451; PMCID: PMC4070777.
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Pulm Circ. 2014 Jun;4(2):319-29. doi: 10.1086/675997.

Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease.

Pulmonary circulation

Marius George Linguraru, John A Pura, Mark T Gladwin, Antony I Koroulakis, Caterina Minniti, Roberto F Machado, Gregory J Kato, Bradford J Wood

Affiliations

  1. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Healthcare System, Washington, DC, USA ; Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA ; School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
  2. Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA ; Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA.
  3. Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  4. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Healthcare System, Washington, DC, USA ; School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
  5. Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
  6. Section of Pulmonary/Critical Care, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
  7. Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland, USA.

PMID: 25006451 PMCID: PMC4070777 DOI: 10.1086/675997

Abstract

Our objective was to determine whether computed tomography angiography (CTA) measurements of pulmonary artery size can noninvasively assess hemodynamics and diagnose pulmonary hypertension (PH) secondary to sickle cell disease (SCD). Twenty SCD patients with confirmed PH were compared with 20 matched controls. Diameters of the pulmonary artery trunk and branches were measured with CTA and a semiautomatic segmentation algorithm. Measurements were normalized by body size and correlated (Spearman rank) with hemodynamic markers from right-heart catheterization. Receiver operating characteristic (ROC) curves were used to investigate the role of pulmonary artery sizes in diagnosing PH. Analysis of pulmonary artery sizes adjusted for body surface area (BSA) resulted in the most significant discrimination between subjects with PH secondary to SCD and controls (P < 0.001); PH was diagnosed accurately with an area under the ROC curve of 0.99. There was significant correlation between pulmonary artery sizes and body mass index (BMI) and BSA only in controls (r = 0.46-0.68, P < 0.04 for all). The most significant correlations with hemodynamic markers were found between BMI-adjusted pulmonary artery sizes and high systolic pulmonary arterial pressure, high pulmonary vascular resistance, high systemic vascular resistance, and low cardiac output (r = 0.47, 0.62, 0.61, and 0.66, respectively; P < 0.04 for all). BMI-adjusted CTA measures of the pulmonary artery relate to high pulmonary vascular resistance and reduced cardiac output in patients with SCD and PH. CTA with quantitative image analysis is a powerful noninvasive diagnostic tool for PH in SCD and shows promise as estimator of hemodynamic markers.

Keywords: CT angiography; arterial size; cardiopulmonary hemodynamics; pulmonary hypertension; quantitative imaging; sickle cell disease

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