Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease

Marius George Linguraru, John A. Pura, Mark T. Gladwin, Antony I. Koroulakis, Caterina Minniti, Roberto Machado, Gregory J. Kato, Bradford J. Wood

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Our objective was to determine whether computed tomography angiography (CTA) measurements of pulmonary artery size can noninvasively assess hemodynamics and diagnose pulmonary hypertension (PH) secondary to sickle cell disease (SCD). Twenty SCD patients with confirmed PH were compared with 20 matched controls. Diameters of the pulmonary artery trunk and branches were measured with CTA and a semiautomatic segmentation algorithm. Measurements were normalized by body size and correlated (Spearman rank) with hemodynamic markers from right-heart catheterization. Receiver operating characteristic (ROC) curves were used to investigate the role of pulmonary artery sizes in diagnosing PH. Analysis of pulmonary artery sizes adjusted for body surface area (BSA) resulted in the most significant discrimination between subjects with PH secondary to SCD and controls (P < 0.001); PH was diagnosed accurately with an area under the ROC curve of 0.99. There was significant correlation between pulmonary artery sizes and body mass index (BMI) and BSA only in controls (r = 0.46–0.68, P < 0.04 for all). The most significant correlations with hemodynamic markers were found between BMI-adjusted pulmonary artery sizes and high systolic pulmonary arterial pressure, high pulmonary vascular resistance, high systemic vascular resistance, and low cardiac output (r = 0.47, 0.62, 0.61, and 0.66, respectively; P < 0.04 for all). BMI-adjusted CTA measures of the pulmonary artery relate to high pulmonary vascular resistance and reduced cardiac output in patients with SCD and PH. CTA with quantitative image analysis is a powerful noninvasive diagnostic tool for PH in SCD and shows promise as estimator of hemodynamic markers.

Original languageEnglish (US)
Pages (from-to)319-329
Number of pages11
JournalPulmonary Circulation
Volume4
Issue number2
DOIs
StatePublished - Jun 1 2014
Externally publishedYes

Fingerprint

Sickle Cell Anemia
Pulmonary Hypertension
Pulmonary Artery
Hemodynamics
Tomography
Vascular Resistance
Body Mass Index
Body Surface Area
ROC Curve
Low Cardiac Output
Body Size
Cardiac Catheterization
Cardiac Output
Arterial Pressure
Lung
Computed Tomography Angiography

Keywords

  • Arterial size
  • Cardiopulmonary hemodynamics
  • CT angiography
  • Pulmonary hypertension
  • Quantitative imaging
  • Sickle cell disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease. / Linguraru, Marius George; Pura, John A.; Gladwin, Mark T.; Koroulakis, Antony I.; Minniti, Caterina; Machado, Roberto; Kato, Gregory J.; Wood, Bradford J.

In: Pulmonary Circulation, Vol. 4, No. 2, 01.06.2014, p. 319-329.

Research output: Contribution to journalArticle

Linguraru, MG, Pura, JA, Gladwin, MT, Koroulakis, AI, Minniti, C, Machado, R, Kato, GJ & Wood, BJ 2014, 'Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease', Pulmonary Circulation, vol. 4, no. 2, pp. 319-329. https://doi.org/10.1086/675997
Linguraru, Marius George ; Pura, John A. ; Gladwin, Mark T. ; Koroulakis, Antony I. ; Minniti, Caterina ; Machado, Roberto ; Kato, Gregory J. ; Wood, Bradford J. / Computed tomography correlates with cardiopulmonary hemodynamics in pulmonary hypertension in adults with sickle cell disease. In: Pulmonary Circulation. 2014 ; Vol. 4, No. 2. pp. 319-329.
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