CT imaging biomarkers to predict severity and prognosis of pulmonary hypertension.
<h4>Purpose</h4>To explore whether there are computed tomography (CT) imaging biomarkers that can stratify the severity of patients with pulmonary hypertension (PH).<h4>Methods</h4>We retrospectively enrolled 144 consecutive patients with suspected PH who underwent CT pulmona...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0313235 |
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| Summary: | <h4>Purpose</h4>To explore whether there are computed tomography (CT) imaging biomarkers that can stratify the severity of patients with pulmonary hypertension (PH).<h4>Methods</h4>We retrospectively enrolled 144 consecutive patients with suspected PH who underwent CT pulmonary angiography and right heart catheterization (RHC). CT findings were analyzed by two observers for large vessel size [ascending aorta (A), pulmonary artery (P), inferior vena cava (IVC)], each chamber size, and septal angle. We investigated the associations between CT imaging parameters and the mean pulmonary artery pressure (mPAP) from RHC. During a median follow-up of 36 months, we observed major adverse cardiovascular events (MACE; all-cause mortality and hospitalization for PH worsening). Univariate and multivariate Cox regression models were used with hazard ratios (HR) and 95% confidence intervals (95% CI) to determine independent predictors of MACE in patients with PH.<h4>Results</h4>Of 144 patients, 116 (80.2%) were diagnosed with PH based on an mPAP of 20 mmHg. Among CT parameters, P, P/A ratio, right ventricle (RV), and RV/left ventricle (LV) ratio were strongly correlated with mPAP values (Pearson's correlation coefficient, all r < 0.001). During the follow-up period, 44 (30.6%) patients developed MACE (14 deaths and 30 hospitalizations). Using multivariate Cox regression analysis, the RV/LV ratio (HR 2.32; 95% CI: 1.17-4.59) was the best predictor of MACE, followed by age (HR 1.03, 95% CI;1.00-1.05) (all p < 0.05). Among various CT parameters, A, P, and P/A ratio showed excellent reliability with intraclass correlation coefficient ≥ 0.95.<h4>Conclusion</h4>Among CT parameters, the RV/LV ratio was the most robust predictor of MACE in patients with PH, while the P and P/A ratios served as reliable indicators reflecting mPAP levels. |
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| ISSN: | 1932-6203 |