+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

CTA-derived left to right atrial size ratio distinguishes between pulmonary hypertension due to heart failure and idiopathic pulmonary arterial hypertension



CTA-derived left to right atrial size ratio distinguishes between pulmonary hypertension due to heart failure and idiopathic pulmonary arterial hypertension



International Journal of Cardiology 223: 723-728



Assessing atrial sizes by routine non-gated CT-angiography (CTA) could be of value in discriminating between pulmonary hypertension (PH) due to heart failure with preserved ejection fraction (HFpEF) and idiopathic pulmonary arterial hypertension (IPAH). We aimed to determine how left (LA) and right atrial (RA) sizes on non-gated CTA can help discriminate between these patients. In an initial study, CMR was used in 15 IPAH and 15 PH-HFpEF patients to determine LA- and RA size throughout the cardiac cycle. While significant variations were noted in LA size over the cardiac cycle, the calculated ratio of left over right atrial size (LA/RA ratio) remained stable in both groups and discriminated between PH-HFpEF and IPAH. In a second study, routine non-gated CTA was used to validate the diagnostic use of a LA/RA ratio in 95 consecutive treatment-naive patients with a final diagnosis of either IPAH (n=64) or PH-HFpEF (n=31). ROC analyses were conducted to determine the discriminative properties of atrial size parameters. On a transversal view, LA size was 19cm2 (±5) in the IPAH group versus 27cm2 (±6) in the PH-HFpEF group (p<0.001). CTA derived LA/RA ratio was significantly higher in PH-HFpEF patients compared to IPAH patients and had good discriminative abilities (AUC=0.833). Assessing LA/RA size ratio by non-gated CTA allows for accurate discrimination between PH-HFpEF and IPAH patients. Because CTA is often available in the early diagnostic work-up, a LA/RA size ratio may guide clinical and diagnostic decision-making, even before invasive hemodynamic measurements.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 057340045

Download citation: RISBibTeXText

PMID: 27573596

DOI: 10.1016/j.ijcard.2016.08.314


Related references

Pulmonary arterial capacitance in children with idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease: relation to pulmonary vascular resistance, exercise capacity, and survival. American Heart Journal 162(3): 562-568, 2011

Capillary pCO2 helps distinguishing idiopathic pulmonary arterial hypertension from pulmonary hypertension due to heart failure with preserved ejection fraction. Respiratory Research 16: 34, 2016

Treatment of pulmonary hypertension caused by left heart failure with pulmonary arterial hypertension-specific therapies: lessons from the right and LEPHT. Circulation 128(5): 475-476, 2013

Relaxin levels in pulmonary hypertension: a comparison between pulmonary arterial hypertension and diastolic heart failure-induced pulmonary hypertension. Journal of Heart and Lung Transplantation 32(3): 371-374, 2013

Sequence variants in BMPR2 and genes involved in the serotonin and nitric oxide pathways in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: relation to clinical parameters and comparison with left heart disease. Respiration; International Review of Thoracic Diseases 79(4): 279-287, 2010

Pulmonary Arterial Reactivity in Heart Failure with Preserved Ejection Fraction Induced Pulmonary Hypertension Similar to Pulmonary Arterial Hypertension. Journal of Cardiac Failure 19(8): S3-S4, 2013

Echocardiographic Pulmonary Left Atrial Ratio (ePLAR): Is it a Clinically Useful, Noninvasive Measure to Help Identify Patients with Left-Heart Causes of Pulmonary Hypertension?. Heart Lung & Circulation 25: S228-S229, 2016

CT derived left atrial size identifies left heart disease in suspected pulmonary hypertension: Derivation and validation of predictive thresholds. International Journal of Cardiology 260: 172-177, 2018

Short-term efficacy of atrial septostomy in the treatment of idiopathic pulmonary arterial hypertension patients complicating with right heart failure. Zhonghua Xin Xue Guan Bing Za Zhi 43(4): 319-322, 2016

Comparison of Pulmonary Artery (PA) Wave Reflections in Pulmonary Arterial Hypertension (PAH) and Pulmonary Hypertension Due to Heart Failure With Preserved Ejection Fraction (PH-HFpEF). Journal of Heart and Lung Transplantation 34(4): S118-S119, 2015

Pulmonary hypertension and right atrial hypertension in the absence of left heart failure are not associated with pleural effusions. American Review of Respiratory Disease 133(4 Suppl.): A130, 1986

Lung neovascularity in pulmonary arterial hypertension associated with congenital heart defects and idiopathic pulmonary arterial hypertension: study of 198 patients. European Radiology 22(5): 1059-1066, 2012

Comparison of 18F-FDG uptake by right ventricular myocardium in idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with congenital heart disease. Pulmonary Circulation 2(3): 365-372, 2012

Platelet-derived growth factor receptor-β and epidermal growth factor receptor in pulmonary vasculature of systemic sclerosis-associated pulmonary arterial hypertension versus idiopathic pulmonary arterial hypertension and pulmonary veno-occlusive disease: a case-control study. Arthritis Research and Therapy 13(2): R61, 2012

Platelet-derived growth factor receptor-beta and epidermal growth factor receptor in pulmonary vasculature of systemic sclerosis-associated pulmonary arterial hypertension versus idiopathic pulmonary arterial hypertension and pulmonary veno-occlusive dise. 2011