scholarly journals CHANGING OF PULMONARY ARTERY DIAMETER IN ACCORDANCE WITH SEVERITY OF COVID-19 (ASSESSMENT BASED ON NON-CONTRAST COMPUTER TOMOGRAPHY)

2021 ◽  
Author(s):  
Alexander F. Aliev ◽  
Nikita D. Kudryavtsev ◽  
Alexey Vladimirovich Petraikin ◽  
Zlata R. Artyukova ◽  
Andrey S. Shkoda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Age Groups ◽  
Lung Parenchyma ◽  
Lung Damage ◽  
High Incidence ◽  
The Relationship ◽  
Pulmonary Artery Diameter

Backgraund: search for the causes of the severe course of COVID-19 by computed tomography of chest, in particular, to clarify the contribution of pulmonary hypertension in the severe course of COVID-19 Aims: To establish the relationship between the expansion of the pulmonary artery and an increase in the severity of COVID-19 pneumonia. Material and methods: This is a retrospective cohort study performed on a group of patients (n = 511, 267 male. Median 59, IQR 49.065.0, min 31 max 84 y.o.) treated in a COVID-19 temporary hospital. Chest CT was performed on a portable computed tomography Airo TruCT (Stryker, USA). The degree of damage of the lung parenchyma was assessed by the CT scale 1(25%); 2(25-50%) 3(50-75%), 4(75%). The diameters of the main pulmonary artery (PA), aorta (Ao) and PA/Ao ratio were measured. Results: The following statistically evident results were obtained: expansion of the pulmonary artery (PA) and PA/Ao ratio increased with rise of the degree of lung damage in COVID-19. Expansion of the aorta was significantly correlated with increasing age of the patients. Discussion: We suggested, this fact and noted expansion of PA in 52.0-65.5% of patients with severe COVID-19 (CT 3-4) is an indicator of a high incidence of pulmonary hypertension in this disease. This requires additional research. Conclusion: It has been shown that the expansion of the pulmonary artery and an increase in the ratio of PA/Ao diameters are associated with an increase in the severity of COVID-19 in all age groups. KEYWORDS COVID-19, pulmonary artery, pulmonary hypertension, aorta, computed tomography.

Predictors of Pulmonary Hypertension on High-resolution Computed Tomography of the Chest in Systemic Sclerosis: A Retrospective Analysis

2010 ◽  
Vol 61 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Anoop Kumar Pandey ◽  
Pearce Wilcox ◽  
John R. Mayo ◽  
Donald Sin ◽  
Robert Moss ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Maximum Diameter ◽  
Imaging Features ◽  
High Resolution Computed Tomography ◽  
Pulmonary Artery Diameter

Purpose To evaluate the imaging features on high-resolution computed tomography (HRCT) of the chest and the clinical parameters that are associated with pulmonary hypertension in systemic sclerosis. We specifically investigated whether main pulmonary artery (MPA) diameter and burden of lung fibrosis are predictors of pulmonary hypertension in these patients. Methods We retrospectively retrieved the database information of patients with systemic sclerosis seen at our hospital between January 2007 and December 2008. A total of 75 patients had HRCT of the chest, pulmonary function testing (PFT), and echocardiography within 6 months of each other. The echocardiography images were reviewed by a level-3 echocardiographer, and 29 cases were excluded because of suboptimal evaluation of pulmonary artery (PA) pressure. Peak PA pressures and PFT of the remaining 46 cases (43 women and 3 men) were charted. The PFT included total lung capacity (TLC), diffusion capacity of lung for carbon monooxide (DLCO) and the ratio of forced expiratory volume in one second and forced vital capacity (FEV1/FVC). The HRCT of the chest of each patient was read by a chest radiologist. The extent of ground glass, reticulation, and honeycombing was objectively scored. The maximum diameter of the main pulmonary artery (MPAD) and ascending aorta were measured. The ratio of main pulmonary artery diameter and ascending aortic diameter (MPAD/AD) and ratio of main pulmonary artery diameter and body surface area (MPAD/BSA) were also calculated. Results Statistical analysis done by using a multivariate model showed that the calculated fibrotic score strongly correlated with peak PA pressures ( P < .001). MPAD ( P = .0175), and the ratio MPAD/AD ( P = .0102) also showed a statistically significant correlation with peak PA pressures. By using stepwise regression analysis, the fibrotic score was found to be the most reliable independent predictor of pulmonary hypertension. Conclusion HRCT-determined severity and extent of pulmonary fibrosis may be helpful in screening for pulmonary hypertension in patients with systemic sclerosis.

Pulmonary arterial elasticity in awake dogs

1993 ◽  
Vol 75 (2) ◽  
pp. 840-848 ◽  
Author(s):  
B. J. Grant ◽  
J. M. Canty ◽  
G. Srinivasan ◽  
A. S. Brody
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Pulmonary Arterial Pressure ◽  
Main Pulmonary Artery ◽  
Arterial Elasticity ◽  
Cross Sectional ◽  
Anesthetized Dogs ◽  
Pulmonary Arterial ◽  
The Relationship ◽  
Made In

We measured the relationship between pulmonary arterial pressure (Ppa), diameter (D), and length of a segment of the main pulmonary artery (MPA) in chronically instrumented conscious dogs breathing spontaneously (CCC). There were no physiologically significant changes in Ppa or D in the CCC dogs postoperatively, and the cross-sectional MPA shape measured by fast computed tomography was nearly circular. These results suggest that the MPA was not distorted by chronic instrumentation. We compared measurements made in the CCC dogs with previous measurements in acutely instrumented anesthetized dogs with open chests (AAO). The elasticity of MPA in the CCC animals was frequency dependent between 1 and 14 Hz and was similar to that in the AAO dogs. Oscillations of D preceded Ppa at cardiac frequencies in the AAO animals, but the D and Ppa oscillations were in phase in the CCC animals. The oscillations of length relative to D were significantly less in the CCC than in the AAO dogs. We conclude that, with limitations, the hemodynamic properties of the MPA can be measured in the CCC subjects. We suggest that the discrepancies between the AAO and CCC dogs can be attributed to differences in extrinsic loading of the MPA.

scholarly journals Increased Pulmonary Artery Diameter on Chest Computed Tomography Can Predict Borderline Pulmonary Hypertension

2013 ◽  
Vol 3 (2) ◽  
pp. 363-368 ◽  
Author(s):  
Tobias J. Lange ◽  
Christian Bornia ◽  
Jaros lava Stiefel ◽  
Christian Stroszczynski ◽  
Michael Arzt ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Chest Computed Tomography ◽  
Pulmonary Artery Diameter

scholarly journals Widespread Parenchymal Abnormalities and Pulmonary Embolism on Contrast-Enhanced CT Predict Disease Severity and Mortality in Hospitalized COVID-19 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Francesca Campoccia Jalde ◽  
Mats O. Beckman ◽  
Ann Mari Svensson ◽  
Max Bell ◽  
Magnus Sköld ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Main Pulmonary Artery ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Parenchymal Abnormalities ◽  
Pulmonary Artery Diameter ◽  
D Dimer

Purpose: Severe COVID-19 is associated with inflammation, thromboembolic disease, and high mortality. We studied factors associated with fatal outcomes in consecutive COVID-19 patients examined by computed tomography pulmonary angiogram (CTPA).Methods: This retrospective, single-center cohort analysis included 130 PCR-positive patients hospitalized for COVID-19 [35 women and 95 men, median age 57 years (interquartile range 51–64)] with suspected pulmonary embolism based on clinical suspicion. The presence and extent of embolism and parenchymal abnormalities on CTPA were recorded. The severity of pulmonary parenchymal involvement was stratified by two experienced radiologists into two groups: lesions affecting ≤50% or &gt;50% of the parenchyma. Patient characteristics, radiological aspects, laboratory parameters, and 60-day mortality data were collected.Results: Pulmonary embolism was present in 26% of the patients. Most emboli were small and peripheral. Patients with widespread parenchymal abnormalities, with or without pulmonary embolism, had increased main pulmonary artery diameter (p &lt; 0.05) and higher C-reactive protein (p &lt; 0.01), D-dimer (p &lt; 0.01), and troponin T (p &lt; 0.001) and lower hemoglobin (p &lt; 0.001). A wider main pulmonary artery diameter correlated positively with C-reactive protein (r = 0.28, p = 0.001, and n = 130) and procalcitonin. In a multivariant analysis, D-dimer &gt;7.2 mg/L [odds ratio (±95% confidence interval) 4.1 (1.4–12.0)] and ICU stay were significantly associated with embolism (p &lt; 0.001). The highest 60-day mortality was found in patients with widespread parenchymal abnormalities combined with pulmonary embolism (36%), followed by patients with widespread parenchymal abnormalities without pulmonary embolism (26%). In multivariate analysis, high troponin T, D-dimer, and plasma creatinine and widespread parenchymal abnormalities on CT were associated with 60-day mortality.Conclusions: Pulmonary embolism combined with widespread parenchymal abnormalities contributed to mortality risk in COVID-19. Elevated C-reactive protein, D-dimer, troponin-T, P-creatinine, and enlarged pulmonary artery were associated with a worse outcome and may mirror a more severe systemic disease. A liberal approach to radiological investigation should be recommended at clinical deterioration, when the situation allows it. Computed tomography imaging, even without intravenous contrast to assess the severity of pulmonary infiltrates, are of value to predict outcome in COVID-19. Better radiological techniques with higher resolution could potentially improve the detection of microthromboses. This could influence anticoagulant treatment strategies, preventing clinical detoriation.

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