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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

Authors
 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 
Citation
 International Journal of Cardiology, Vol.243 : 460-465, 2017 
Journal Title
 International Journal of Cardiology 
ISSN
 0167-5273 
Issue Date
2017
MeSH
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
Keywords
Cardiac computed tomography ; Pulmonary artery ; Pulmonary hypertension ; Sudden cardiac death
Abstract
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160873
Full Text
https://www.sciencedirect.com/science/article/pii/S0167527317319125
DOI
10.1016/j.ijcard.2017.05.090
Appears in Collections:
1. Journal Papers (연구논문) > 5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
성지민(Sung, Ji Min)
심지영(Shim, Chi Young)
장혁재(Chang, Hyuck Jae)
정남식(Chung, Nam Sik)
정조원(Jung, Jo Won)
조인정(Cho, In Jeong)
홍그루(Hong, Geu Ru)
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