title: Diagnostic accuracy of echocardiography combined with chest CT in pulmonary hypertension.
abstract: BACKGROUND
  Transthoracic echocardiography (TTE) and computerized axial tomography (CT) are complementary imaging techniques. It is possible that a combination of the two may offer a better way of identifying pulmonary hypertension (PH) than either one alone.
  
  
  OBJECTIVE
  To determine the diagnostic accuracy of TTE combined with chest CT in pulmonary hypertension.
  
  
  METHODS
  We performed a retrospective review of consecutive patients who had undergone TTE, CT and right heart catheterization (RHC) between 7/1/2008 and 6/30/2012. PH was defined as systolic pulmonary artery pressure >40 mm Hg or tricuspid regurgitant (TR) jet velocity >2.8m/s on TTE, ratio of diameter of pulmonary artery to ascending aorta (rPA) >1 or diameter of PA (dPA) >30 mm on CT, and mean PAP (mPAP) >25 mm Hg on RHC.
  
  
  RESULTS
  There was a total of 87 patients. The mean ± SD age was 54.3 ± 15.9 years and 69 (79%) were female. The prevalence of PH was 75%. The mean ± SD mPAP was 35.8 ± 14.2 mm Hg. The majority of the patients belonged to World Health Organization group I PH. Fifty per cent of the CT scans were done with intravenous contrast dye. The combination of TR jet velocity and rPA provided the best combination of sensitivity (98%) and specificity (70%) with an ROC area under the curve of 0.84.
  
  
  CONCLUSIONS
  The combination of TTE and chest CT is better than either imaging technique alone in identifying patients with PH in a heterogeneous population and may exclude PH.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University at Buffalo, SUNY, Buffalo, NY, USA.
authors.forename: Adil
authors.identifier: http://orcid.org/0000-0003-1333-4934
authors.initials: A
authors.lastname: Shujaat
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida at Jacksonville, Jacksonville, FL, USA.
authors.forename: Abubakr A
authors.initials: AA
authors.lastname: Bajwa
authors.affiliation: Division of Cardiology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Farah
authors.initials: F
authors.lastname: Al-Saffar
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida at Jacksonville, Jacksonville, FL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Bellardini
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida at Jacksonville, Jacksonville, FL, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida at Jacksonville, Jacksonville, FL, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Cury
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: chest CT; diagnosis; echocardiography; pulmonary hypertension