title: Left Atrial Area and Right Ventricle Dimensions in Non-gated Axial Chest CT can Differentiate Pulmonary Hypertension Due to Left Heart Disease from Other Causes.
abstract: BACKGROUND
  It is unknown whether axial non-gated CT can distinguish World Health Organization Group 2 pulmonary hypertension (pulmonary hypertension due to left heart disease) from non-Group 2 pulmonary hypertension.
  
  
  OBJECTIVE
  The study was performed to identity imaging parameters in non-gated chest CT that differentiate Group 2 from non-Group 2 pulmonary hypertension.
  
  
  METHODS
  Among 158 patients who underwent right heart catheterization for evaluation of pulmonary hypertension, 112 had sufficient data and chest CT for review. Invasive hemodynamic data and numerous variables obtained from axial CT images (maximum diameters of main, right, left pulmonary arteries, ascending aorta, main pulmonary artery to ascending aorta diameter ratio, right atrial diameter, left atrial area and right ventricular size) were collected. CT variables were validated against hemodynamic data to identify parameters that would allow to differentiate pulmonary hypertension due to left heart disease (Group 2) from non-Group 2 pulmonary hypertension.
  
  
  RESULTS
  Based on right heart catheterization data, we identified 53 patients with Group 2 pulmonary hypertension, 50 patients with non-Group 2 pulmonary hypertension, and 9 subjects with no pulmonary hypertension. In patients with a dilated pulmonary artery (n = 84), the ROC curve for left atrial area (area under the ROC curve 0.76 ± 0.06) independently distinguished patients with Group 2 pulmonary hypertension (n = 42) from patients with non-Group 2 pulmonary hypertension (n = 42). A dilated left atrium (>20 mm(2)) in combination with a normal right ventriuclar size had a sensitivity of 77% and specificity of 94% for Group 2 pulmonary hypertension.
  
  
  CONCLUSIONS
  In patients with a dilated pulmonary artery on chest CT, left atrial area and right ventricular dimensions may aid to diagnose pulmonary hypertension and to distinguish underlying cardiac disease from other causes.
authors: Cardiovascular Division, VA Central California Health System, Fresno, 2615 E Clinton Ave, CA 93703, USA; UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA. Electronic address: katikireddy@gmail.com.
authors: Chandra K
authors: CK
authors: Katikireddy
authors: UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
authors: Manmeet
authors: M
authors: Singh
authors: UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
authors: Kamil
authors: K
authors: Muhyieddeen
authors: UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
authors: Tushar
authors: T
authors: Acharya
authors: UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
authors: John A
authors: JA
authors: Ambrose
authors: UCSF Fresno, Cardiovascular Division, 2823 Fresno St, Fresno, CA 93721, USA.
authors: Arang
authors: A
authors: Samim
mesh_terms: D019540:Area Under Curve; D064752:Atrial Remodeling; D002140:California; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D020257:Ventricular Remodeling
keywords: Axial chest CT; Dilated pulmonary artery; Left atrium; Pulmonary hypertension group 2; Right heart catheterization; Right ventricle