title: Characteristic Features on Morphologic and Topographic Findings of Pulmonary Vein Orifices in Transition From Diastolic Dysfunction to Heart Failure: A Computerized Tomography Study.
abstract: BACKGROUND
  Diastolic dysfunction (DD), a precursor to clinical heart failure (HF), has traditionally been evaluated by means of echocardiography. Data regarding morphologic descriptions of pulmonary vein (PV) orifices in transition from DD to HF have been lacking.
  
  
  RESULTS
  We retrospectively studied 124 subjects with computerized tomography (CT)-derived PV parameters and echocardiography-derived diastolic indices. We categorized our subjects as 1) non-DD, 2) DD, or 3) heart failure with preserved ejection fraction (HFpEF) and observed a graded enlargement for 4 PV orifice areas across these groups. Positive linear relationship between the 4 PV orifice areas, echocardiography-derived mean pulmonary capillary wedge pressure (PCWP), and velocity of propagation (VP) were observed. Finally, maximum areas of left superior pulmonary vein (LSPV) and left inferior pulmonary vein (LIPV) significantly increased clinical diagnosis of HFpEF (likelihood-ratio χ(2): from 42.92 to 50.75 and 54.67 for LSPV and LIPV, respectively) when superimposed on left ventricular mass index, PCWP, and left atrial volume.
  
  
  CONCLUSIONS
  PV size measurements with the use of CT are feasible and further aid in diseases discrimination between preclinical DD and those progressed into HF, even with preserved global pumping. Our data suggest that CT-based PV measures may help to identify subjects at risk for HF.
authors.affiliation: Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Sho-Ting
authors.initials: ST
authors.lastname: Hung
authors.affiliation: Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Biomedical Imaging and Radiologic Sciences, National Yang Ming University, Taipei, Taiwan.
authors.forename: Chun-Ho
authors.initials: CH
authors.lastname: Yun
authors.affiliation: Department of Biomedical Imaging and Radiologic Sciences, National Yang Ming University, Taipei, Taiwan.
authors.forename: Tung-Hsin
authors.initials: TH
authors.lastname: Wu
authors.affiliation: Department of Biomedical Imaging and Radiologic Sciences, National Yang Ming University, Taipei, Taiwan.
authors.forename: Fei-Shih
authors.initials: FS
authors.lastname: Yang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College and Mackay Medicine Nursing and Management College, Taipei, Taiwan.
authors.forename: Jen-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College and Mackay Medicine Nursing and Management College, Taipei, Taiwan. Electronic address: jotaro3791@gmail.com.
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College and Mackay Medicine Nursing and Management College, Taipei, Taiwan.
authors.forename: Charles Jia-Yin
authors.initials: CJ
authors.lastname: Hou
authors.affiliation: Department of Medicine, Mackay Medical College and Mackay Medicine Nursing and Management College, Taipei, Taiwan.
authors.forename: Shun-Chuan
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Cardiovascular Department, University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Anas
authors.initials: A
authors.lastname: Fares
authors.affiliation: Cardiovascular Department, University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Lemba Dina
authors.initials: LD
authors.lastname: Nshisso
authors.affiliation: Cardiovascular MRI and CT Program, Baptist Cardiac Vascular Institute, Miami, Florida.
authors.forename: Ricardo C
authors.initials: RC
authors.lastname: Cury
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College and Mackay Medicine Nursing and Management College, Taipei, Taiwan.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
authors.affiliation: Cardiovascular Department, University Hospitals Case Medical Center, Cleveland, Ohio.
authors.forename: Hiram G
authors.initials: HG
authors.lastname: Bezerra
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Diastolic dysfunction; heart failure with preserved ejection fraction (HFpEF); orifice areas; pulmonary vein