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Right to left ventricular diameter ratio on pulmonary angio-CT. Is there a correlation with hemodynamics in CTEPH?
Session:
Painel 10 - Doença Valvular 10
Speaker:
Pedro Alves Da Silva
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.3 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Pedro Alves Da Silva; Rui Plácido; Tatiana Guimarães; Joana Rigueira; Tiago Graça Rodrigues; Nelson P. Cunha; Beatriz Silva ; Joana Brito; Paula Campos; Ana G. Almeida; Ana Mineiro; Nuno Lousada; Fausto José Pinto
Abstract
<p><strong>Introduction: </strong>In acute pulmonary embolism several studies showed that right ventricle (RV) dilatation based on right-to-left ventricle diameter ratio (RV/LVd) assessed by pulmonary angio-CT is a measure of RV dysfunction and correlates well with echocardiographic and hemodynamic parameters to predict outcomes. In CTEPH patients the role of these measurements is still not established.</p> <p><strong>Purpose: </strong>To evaluate the relationship between RV/LVd by pulmonary angio-CT and invasive hemodynamic parameters assessed by right cardiac catheterization.</p> <p><strong>Methods: </strong>Retrospective single-center study of consecutive CTEPH patients. Demographic, clinical, laboratorial, imaging and hemodynamic data were collected. RV/LVd was measured on the standard axial view and in the true 4-chamber view. For statistical analysis Pearson and Spearman correlation were used to continuous variables and Mann-Whitney test if the variables were categorical.</p> <p><strong>Results: </strong>We included 24 CTEPH patients (pts) with mean age of 59.7±12.9 years, 54.2% were female. 20.8% of pts had congenital thrombophilia and 12.5% antiphospholipid syndrome. The majority (87.5%) of patients were under specific pulmonary vasodilator therapy, all the pts were anticoagulated and all of them underwent pulmonary endarterectomy. Functional class was WHO 2 in 33% WHO 3 in 67%.</p> <p>In our population, axial RV/LVd showed correlation with pulmonary artery systolic pressure (PASP) (p=0,046 R=0,42); mean pulmonary artery pressure (mPAP) (p=0,015, R=0,502); cardiac output (CO) and pulmonary vascular resistance (PVR) (p=0.013 R=-0.532 and p<0.001 R 0.964, respectively). In the true 4-chamber view RV/LVd correlated with CO (p=0.014 R=0.518), PVR (respectively; p=0.024 R=0.502) and transpulmonary pressure gradient (TPG) (p=0.031 R=0.484).</p> <p>We also analysed the RV/LV area ratio and we observed a correlation with PASP (p=0.019 R=0.497); mPAP (p=0.002 R=0.627); CO (p=0.035 R=-0.461); PVR (p=0.001 OR=0.677) and TPG (GGT p=0.032 R=0.48).</p> <p><strong>Conclusion: </strong>These findings suggest that the measurement of RV/LVd on pulmonary angio-CT can add important information, correlating with hemodynamics. Furthermore, axial determinations</p>
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