title: Cardiac Dual-source Computed Tomography for the Detection of Left Main Compression Syndrome in Patients with Pulmonary Hyper-tension.
abstract: BACKGROUND
  Left Main Compression Syndrome (LMCS) represents an entity described as the extrinsic compression of the left main coronary artery (LMCA) by a dilated pulmonary artery (PA) trunk. We examined the presence of LMCS in patients with pulmonary hypertension (PH) using dual-source computed tomography (DSCT), as a non-invasive diagnostic tool.
  
  
  METHODS
  The following parameters were measured: PA trunk diameter (PAD), the distance between PAD and LMCA (LMPA) and the distance between PA and aorta (AoPA). These measurements were related with demographic, echocardiographic, hemodynamic and clinical parameters. Angiography was performed in two patients with LMCS suspected by cardiac computed tomographic angiography. Patients without PH but with angina were examined as controls, using DSCT cardiac angiography to assess the same measurements and to detect the prevalence of coronary artery disease.
  
  
  RESULTS
  PA diameter value over 40.00 mm has been associated with PH and LMCS. Furthermore, LMCS did not occur at a distance smaller than 0.50 mm between the PA and the LMCA, and did not correlate with the distance between the PA and the aorta or with cardiac index and NT-proBNP.
  
  
  CONCLUSIONS
  DSCT may represent the initial testing modality in PH patients with dilated PA trunk to exclude LMCS. A periodical rule-out of this rare entity, as assessed by DSCT, in patients with a severely dilated PA seems to be mandatory for PH patients contributing to survival improvement.
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Eftychia
authors: E
authors: Demerouti
authors: Interventional Cardiology Department, Mediterraneo Hospital, Athens, Greece.
authors: Athanassios
authors: A
authors: Manginas
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Emmanouil
authors: E
authors: Petrou
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Spyridoula
authors: S
authors: Katsilouli
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Panagiotis
authors: P
authors: Karyofillis
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: George
authors: G
authors: Athanassopoulos
authors: Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: George
authors: G
authors: Karatasakis
authors: First Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Ioannis
authors: I
authors: Iakovou
authors: General Hospital of Kymi, Kymi, Greece.
authors: Konstantinos
authors: K
authors: Mihas
authors: Imaging Department, Onassis Cardiac Surgery Center, Athens, Greece.
authors: Irene
authors: I
authors: Mastorakou
keywords: Cardiac computed tomography; Left main compression; Non-invasive technique; Pulmonary hypertension