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To evaluate the morphological and functional parameters of right ventricle (RV) in subjects with pulmonary hypertension (PH) by ECG-gated enhanced 320 slice CT.
56 PH subjects (15 males, 57±15 yrs, 33 chronic thromboembolic PH, 21 pulmonary arterial hypertension and 2 others) underwent retrospective ECG-gated 320 slice CT. CT images were reconstructed every 5% from 0-95% of ECG R-to-R interval and 4 dimensional (4D) images were obtained. Subjects were followed for a median of 9.5 months.
Adverse events (AE) occurred in 8 subjects (4 males, 60±11 years); all cause death (2), heart failure (5), cerebral hemorrhage (1). RV asynergy was observed in 26 subjects on CT. Receiver operating characteristic (ROC) curves of RV end-diastolic volume (RVEDV) and end-systolic volume (RVESV) on CT showed area under curve (AUC) of 0.669 and 0.641, respectively, and best cutoff points of 125.2 mm3(sensitivity 75.0%, specificity 58.3%) and 113.5 mm3(sensitivity 62.5%, specificity 79.2%), respectively, to distinguish subjects with and without AEs. By Kaplan Meier analysis, there was a significant differences in incidence of AEs between ≥ and <113.5 mm3of RVESV on CT (P=0.025). In a similar analysis, AE was more frequent in subjects with RV wall asynergy on CT than in those without (P=0.039).
Quantitative and qualitative morphological and functional evaluation of RV on 4D images of ECG gated 320 slice CT showing RVESV and RV wall asynergy can predict short term poor prognosis in PH subjects.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Pulmonary Hypertension Imaging
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1123-153
- 2013 American College of Cardiology Foundation