Academic radiology · 2020
Detection of Pulmonary Hypertension by Combining Echocardiography and Chest Radiography.
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Yang Song, Lei Si, Peng Fei, Wu Shang-Jie
Аннотация
RATIONALE AND OBJECTIVES: In pulmonary hypertension (PH) patients, chest radiographs often show an increase in the diameter of the right descending pulmonary artery (RDPA). The purpose of this study is to evaluate whether a combination of echocardiography and chest radiography for detecting PH is more accurate than echocardiography alone.
MATERIALS AND METHODS: Between 2013 and 2019, a total of 1301 patients were included in this study. Among them, 1030 patients with congenital heart disease (CHD) were used to establish a linear regression model by combining echocardiographic and chest radiographic variables, and 136 CHD patients and 135 non-CHD patients were used to compare the accuracy between a new model and the 2015 ESC/ERS guidelines for right heart catheterization recommendation. The chest radiographic diameter of the RDPA, and the echocardiography-measured tricuspid regurgitation pressure gradient and the main pulmonary artery diameter were assessed.
RESULTS: The TG-RDPA composite index correlated more strongly than either the TG or RDPA (r = 0.741 vs 0.709 or 0.544; both p value <0.001). The TG-RDPA composite index was more accurate in detecting PH than the ESC/ERS 2015 guidelines (overall accuracy: 83.8% vs 77.1%; missed diagnoses rate: 12.0% vs 22.5%). The overall accuracy of the main pulmonary artery-RDPA composite index (r = 0.599, p value <0.001) was 84.1% compared to overall accuracy of 77.1% using the ESC/ERS 2015 guidelines.
CONCLUSION: A combination of echocardiography and chest X-ray may be a more accurate way to detect PH and an alternative method for suspected PH patients without tricuspid regurgitation velocity.
MATERIALS AND METHODS: Between 2013 and 2019, a total of 1301 patients were included in this study. Among them, 1030 patients with congenital heart disease (CHD) were used to establish a linear regression model by combining echocardiographic and chest radiographic variables, and 136 CHD patients and 135 non-CHD patients were used to compare the accuracy between a new model and the 2015 ESC/ERS guidelines for right heart catheterization recommendation. The chest radiographic diameter of the RDPA, and the echocardiography-measured tricuspid regurgitation pressure gradient and the main pulmonary artery diameter were assessed.
RESULTS: The TG-RDPA composite index correlated more strongly than either the TG or RDPA (r = 0.741 vs 0.709 or 0.544; both p value <0.001). The TG-RDPA composite index was more accurate in detecting PH than the ESC/ERS 2015 guidelines (overall accuracy: 83.8% vs 77.1%; missed diagnoses rate: 12.0% vs 22.5%). The overall accuracy of the main pulmonary artery-RDPA composite index (r = 0.599, p value <0.001) was 84.1% compared to overall accuracy of 77.1% using the ESC/ERS 2015 guidelines.
CONCLUSION: A combination of echocardiography and chest X-ray may be a more accurate way to detect PH and an alternative method for suspected PH patients without tricuspid regurgitation velocity.