Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective
Objectives: Pulmonary hypertension (PH) is an important physiologic variable in the assessment of patients undergoing major thoracic operations but all too often neglected because of the need for right heart catheterization (RHC) due to the inaccuracy of transthoracic echocardiography. Patients with...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266625072300473X |
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| author | Nathaniel Deboever, MD, MSc George A. Eapen, MD Roberto F. Casal, MD Jean-Bernard Durand, MD Michael A. Eisenberg, MD Hope Feldman, MD, MSc Celestino May, MD, MAEd Zohra Ali, APRN, MSc David C. Rice, MB, BCh Reza J. Mehran, MDCM, MSc |
| author_facet | Nathaniel Deboever, MD, MSc George A. Eapen, MD Roberto F. Casal, MD Jean-Bernard Durand, MD Michael A. Eisenberg, MD Hope Feldman, MD, MSc Celestino May, MD, MAEd Zohra Ali, APRN, MSc David C. Rice, MB, BCh Reza J. Mehran, MDCM, MSc |
| author_sort | Nathaniel Deboever, MD, MSc |
| collection | DOAJ |
| description | Objectives: Pulmonary hypertension (PH) is an important physiologic variable in the assessment of patients undergoing major thoracic operations but all too often neglected because of the need for right heart catheterization (RHC) due to the inaccuracy of transthoracic echocardiography. Patients with lung cancer often require endobronchial ultrasound (EBUS) as part of the staging of the cancer. We sought to investigate whether EBUS can be used to screen these patients for PH. Methods: Patients undergoing a major thoracic operation requiring EBUS for staging were included prospectively in the study. All patients had also a RHC (gold standard). We aimed to compare the pulmonary artery pressure measurements by EBUS with the RHC values. Results: A total of 20 patients were enrolled in the study. The prevalence of abnormal pulmonary artery pressure was 65% based on RHC. All patients underwent measurement of the pulmonary vascular acceleration time (PVAT) by EBUS with no adverse events. Linear regression analysis comparing PVAT and RHC showed a correlation (r = −0.059, −0.010 to −0.018, P = .007). A receiver operator characteristic curve (area under the curve = 0.736) was used to find the optimal PVAT threshold (140 milliseconds) to predict PH; this was used to calculate a positive and negative likelihood ratio following a positive diagnosis of 2.154 and 0.538, respectively. Conclusions: EBUS interrogation of pulmonary artery hemodynamic is safe and feasible. EBUS may be used as a screening test for PH in high-risk individuals. |
| format | Article |
| id | doaj-art-d1e08fc011c8489987f153ae56c0b791 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-d1e08fc011c8489987f153ae56c0b7912025-08-20T03:36:38ZengElsevierJTCVS Techniques2666-25072024-02-012314615310.1016/j.xjtc.2023.10.030Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspectiveNathaniel Deboever, MD, MSc0George A. Eapen, MD1Roberto F. Casal, MD2Jean-Bernard Durand, MD3Michael A. Eisenberg, MD4Hope Feldman, MD, MSc5Celestino May, MD, MAEd6Zohra Ali, APRN, MSc7David C. Rice, MB, BCh8Reza J. Mehran, MDCM, MSc9Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Cardiology, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TexDepartment of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Tex; Address for reprints: Reza J. Mehran, MDCM, MSc, Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.Objectives: Pulmonary hypertension (PH) is an important physiologic variable in the assessment of patients undergoing major thoracic operations but all too often neglected because of the need for right heart catheterization (RHC) due to the inaccuracy of transthoracic echocardiography. Patients with lung cancer often require endobronchial ultrasound (EBUS) as part of the staging of the cancer. We sought to investigate whether EBUS can be used to screen these patients for PH. Methods: Patients undergoing a major thoracic operation requiring EBUS for staging were included prospectively in the study. All patients had also a RHC (gold standard). We aimed to compare the pulmonary artery pressure measurements by EBUS with the RHC values. Results: A total of 20 patients were enrolled in the study. The prevalence of abnormal pulmonary artery pressure was 65% based on RHC. All patients underwent measurement of the pulmonary vascular acceleration time (PVAT) by EBUS with no adverse events. Linear regression analysis comparing PVAT and RHC showed a correlation (r = −0.059, −0.010 to −0.018, P = .007). A receiver operator characteristic curve (area under the curve = 0.736) was used to find the optimal PVAT threshold (140 milliseconds) to predict PH; this was used to calculate a positive and negative likelihood ratio following a positive diagnosis of 2.154 and 0.538, respectively. Conclusions: EBUS interrogation of pulmonary artery hemodynamic is safe and feasible. EBUS may be used as a screening test for PH in high-risk individuals.http://www.sciencedirect.com/science/article/pii/S266625072300473Xendobronchial ultrasoundhigh risk lung resectionpreoperative screeningpulmonary hypertension |
| spellingShingle | Nathaniel Deboever, MD, MSc George A. Eapen, MD Roberto F. Casal, MD Jean-Bernard Durand, MD Michael A. Eisenberg, MD Hope Feldman, MD, MSc Celestino May, MD, MAEd Zohra Ali, APRN, MSc David C. Rice, MB, BCh Reza J. Mehran, MDCM, MSc Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective JTCVS Techniques endobronchial ultrasound high risk lung resection preoperative screening pulmonary hypertension |
| title | Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective |
| title_full | Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective |
| title_fullStr | Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective |
| title_full_unstemmed | Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective |
| title_short | Endobronchial ultrasound: A novel screening test for pulmonary hypertension prior to major pulmonary surgeryCentral MessagePerspective |
| title_sort | endobronchial ultrasound a novel screening test for pulmonary hypertension prior to major pulmonary surgerycentral messageperspective |
| topic | endobronchial ultrasound high risk lung resection preoperative screening pulmonary hypertension |
| url | http://www.sciencedirect.com/science/article/pii/S266625072300473X |
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