Axial CT measured main pulmonary artery diameter to predict the presence and degree of pulmonary hypertension

Abstract

We performed this study to investigate if main pulmonary artery (mPA) diameter measured by axial chest computed tomography (CT) can predict the presence and degree of echocardiography-measured pulmonary hypertension (ePH) among emergency department (ED) patients. This retrospective cross-sectional study enrolled patients who underwent both chest CT and echocardiography within 24 h at the ED. The ePH was estimated using right ventricular systolic pressure (RVSP). RVSP <40 mmHg was classified as normal; 40–49 mmHg, mild ePH; 50–75 mmHg, moderate ePH; and ≥76 mmHg, severe ePH. Among 485 adult patients, 297 (61.2%) had normal RVSP and mean mPA of 30.3 mm. The numbers of patients with mild, moderate and severe ePH were 92 (19.0%), 85 (17.5%) and 11 (2.3%) with corresponding mean mPA diameters of 32.4, 34.5 and 35.9 mm, respectively. The best mPA diameters for predicting mild, moderate and severe ePH were 30.6, 31.8 and 33.8 mm, with area under the receiver operating characteristic curve of 0.697, 0.727 and 0.797 and sensitivities of 72.9%, 71.9% and 81.8%, respectively. Axial CT-measured mPA diameter can predict the presence and degree of ePH among ED patients. If the CT-measured mPA diameter is greater than 30.6 mm, the possibility of pulmonary hypertension should be considered and applied to the patient’s treatment.