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Detection of mechanical complications related to the potential risk of sudden cardiac death in patients with pulmonary arterial hypertension by computed tomography

 Sang-Eun Lee  ;  Ji Hyun Im  ;  Ji Min Sung  ;  In-Jeong Cho  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Namsik Chung  ;  Jo Won Jung  ;  Hyuk-Jae Chang 
 International Journal of Cardiology, Vol.243 : 460-465, 2017 
Journal Title
 International Journal of Cardiology 
Issue Date
Adult ; Aneurysm, Dissecting/diagnostic imaging ; Aneurysm, Dissecting/etiology ; Aneurysm, Dissecting/mortality ; Cross-Sectional Studies ; Death, Sudden, Cardiac/epidemiology* ; Dilatation, Pathologic/diagnostic imaging ; Dilatation, Pathologic/etiology ; Dilatation, Pathologic/mortality ; Female ; Humans ; Hypertension, Pulmonary/complications ; Hypertension, Pulmonary/diagnostic imaging* ; Hypertension, Pulmonary/mortality* ; Male ; Middle Aged ; Pulmonary Artery/diagnostic imaging ; Risk Factors ; Tomography, X-Ray Computed*/methods
Cardiac computed tomography ; Pulmonary artery ; Pulmonary hypertension ; Sudden cardiac death
BACKGROUND: We explored the value of cardiac computed tomography (CT) for the detection and prediction of mechanical complications related to the risk of sudden cardiac death (SCD) in pulmonary arterial hypertension (PAH) patients. METHODS: PAH patients (n=60, mean age 47±15, 31.7% male) with pulmonary artery (PA) enlargement (≥40mm) by echocardiography were studied with cardiac CT. Complications explored were the presence of left main coronary artery (LM) compression, airway compression, PA dissection and PA thrombosis in relation to diameters of main PA (MPA) which were measured in (1) axial plane (MPAAx) and (2) LM oblique view (MPALMobq). RESULTS: Mechanical complications were found in 21 patients (35.0%): LM compression in 20 patients; airway compression in 3 patients; and PA thrombosis in 4 patients. Patients with complications had more dilated MPALMobq than patients without complication (59.4±13.0mm vs. 42.4±7.0mm, p<0.001). The area under the receiver operating characteristic curve for MPALMobq was 0.889 (95% confidence interval: 0.795 to 0.983, p<0.001) with the highest discriminating sensitivity and specificity being 90.5% and 69.2%, respectively at MPALMobq of 45mm. MPAAx failed to predict the presence of mechanical complications (p>0.05). CONCLUSION: MPALMobq≥45mm was significantly associated with the presence of mechanical complications of PAH. Evaluation with CT should be considered in PAH patients with dilated MPA.
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5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Sung, Ji Min(성지민)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Sang Eun(이상은) ORCID logo https://orcid.org/0000-0001-6645-4038
Chang, Hyuck Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Jung, Jo Won(정조원)
Cho, In Jeong(조인정)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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