CT scan-measured pulmonary artery to aorta ratio and echocardiography for detecting pulmonary hypertension in severe COPD.

Abstract:

BACKGROUND:COPD is associated with significant morbidity primarily driven by acute exacerbations. Relative pulmonary artery (PA) enlargement, defined as a PA to ascending aorta (A) diameter ratio greater than one (PA:A>1) identifies patients at increased risk for exacerbations. However, little is known about the correlation between PA:A, echocardiography, and invasive hemodynamics in COPD. METHODS:A retrospective observational study of patients with severe COPD being evaluated for lung transplantation at a single center between 2007 and 2011 was conducted. Clinical characteristics, CT scans, echocardiograms, and right-sided heart catheterizations were reviewed. The PA diameter at the bifurcation and A diameter from the same CT image were measured. Linear and logistic regression were used to examine the relationships between PA:A ratio by CT scan and PA systolic pressure (PASP) by echocardiogram with invasive hemodynamics. Receiver operating characteristic analysis assessed the usefulness of the PA:A ratio and PASP in predicting resting pulmonary hypertension (PH) (mean pulmonary artery pressure [mPAP]>25 mm Hg). RESULTS:Sixty patients with a mean predicted FEV1 of 27%±12% were evaluated. CT scan-measured PA:A correlated linearly with mPAP after adjustment for multiple covariates (r=0.30, P=.03), a finding not observed with PASP. In a multivariate logistic model, mPAP was independently associated with PA:A>1 (OR, 1.44; 95% CI, 1.02-2.04; P=.04). PA:A>1 was 73% sensitive and 84% specific for identifying patients with resting PH (area under the curve, 0.83; 95% CI, 0.72-0.93; P<.001), whereas PASP was not useful. CONCLUSIONS:A PA:A ratio>1 on CT scan outperforms echocardiography for diagnosing resting PH in patients with severe COPD.

journal_name

Chest

journal_title

Chest

authors

Iyer AS,Wells JM,Vishin S,Bhatt SP,Wille KM,Dransfield MT

doi

10.1378/chest.13-1422

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

824-832

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)35953-5

journal_volume

145

pub_type

杂志文章

相关文献

CHEST文献大全
  • Atrial fibrillation following pulse methylprednisolone therapy in an adult.

    abstract::The authors believe this to be the first case report of atrial fibrillation following pulse methylprednisolone therapy in an adult. The literature regarding the complications of pulse methylprednisolone therapy is reviewed, with particular emphasis on the incidence and pathogenesis of arrhythmias. ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.2.622

    authors: McLuckie AE,Savage RW

    更新日期:1993-08-01 00:00:00

  • Validation of the modified multisystem organ failure score as a predictor of mortality in patients with AIDS-related Pneumocystis carinii pneumonia and respiratory failure.

    abstract:STUDY OBJECTIVES:To validate a previously developed multisystem organ failure (MSOF) score with and without the addition of the lactate dehydrogenase (LDH) level as a predictor of survival to hospital discharge in patients with AIDS-related Pneumocystis carinii pneumonia (PCP) and acute respiratory failure (ARF). DESI...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.114.1.199

    authors: Forrest DM,Djurdjev O,Zala C,Singer J,Lawson L,Russell JA,Montaner JS

    更新日期:1998-07-01 00:00:00

  • Prediction of postoperative performance status in patients with giant bulla.

    abstract::To predict the postoperative improvement in performance status after bullectomy, preoperative pulmonary function and dyspneic grade were evaluated in 20 patients with giant bulla. The patients were divided into two groups, based on postoperative performance status: group 1 consisted of 15 patients with improved status...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.3.668

    authors: Ohta M,Nakahara K,Yasumitsu T,Ohsugi T,Maeda M,Kawashima Y

    更新日期:1992-03-01 00:00:00

  • The role of open lung biopsy in patients with the acquired immunodeficiency syndrome.

    abstract::To assess the role of open lung biopsy in patients with the acquired immunodeficiency syndrome (AIDS), we retrospectively reviewed the cases of 42 patients with AIDS who underwent this procedure for the diagnosis of pulmonary infiltrates. Four patients had no preceding bronchoscopy because the severity of the respirat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.91.5.659

    authors: Fitzgerald W,Bevelaqua FA,Garay SM,Aranda CP

    更新日期:1987-05-01 00:00:00

  • Increase in atrial natriuretic factor in the lungs, heart, and circulatory system owing to ozone.

    abstract::Ozone can cause pulmonary edema and simultaneously decrease blood pressure. Atrial natriuretic factor (ANF) may mediate both of these effects in that it increases pulmonary capillary permeability resulting in edema formation and vasodilates the vascular system. The present investigation was designed to test directly t...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.5.1551

    authors: Vesely DL,Giordano AT,Raska-Emery P,Montgomery MR

    更新日期:1994-05-01 00:00:00

  • Bilateral diaphragm paralysis treated with cuirass ventilation.

    abstract::The therapeutic effects of cuirass ventilation were studied in two patients with bilateral diaphragm paralysis. Negative inspiratory and positive expiratory pressure applied to the cuirass shell was transmitted to the abdominal and thoracic cavities. Diaphragm excursion was enhanced. Nocturnal cuirass ventilation appe...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.92.4.683

    authors: Driver AG,Blackburn BB,Marcuard SP,Austin EH Jr

    更新日期:1987-10-01 00:00:00

  • Reintubation as an outcome predictor in trauma patients.

    abstract:STUDY OBJECTIVE:Determine reintubation rate, identify its cause, and detail adverse outcomes from reintubation. DESIGN:Retrospective review of extubation failures in the trauma ICU. SETTING:University hospital and regional trauma center. PATIENTS:Four hundred five patients arriving intubated or requiring intubation ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.6.1577

    authors: Daley BJ,Garcia-Perez F,Ross SE

    更新日期:1996-12-01 00:00:00

  • Detection of unstable angina by 99m technetium pyrophosphate myocardial scintigraphy.

    abstract::99mTechnetium stannous pyrophosphate has been shown to accumulate in acutely infarcted myocardium. To determine if the isotope is also taken up by severely ischemic, but not necrotic myocardium, we performed myocardial scintigraphic studies in 17 patients with chest pains. Seven of the patients satisfied conventional ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.69.2.168

    authors: Abdulla AM,Canedo MI,Cortez BC,McGinnis KD,Wilhelm SK

    更新日期:1976-02-01 00:00:00

  • Efficacy of 67Ga-scintigraphy in predicting the diagnostic yield of transbronchial lung biopsy in pulmonary sarcoidosis.

    abstract::Nineteen consecutive patients with clinically suspected sarcoidosis underwent 67Ga-scintigraphy prior to transbronchial lung biopsy (TBLB) to determine if 67Ga uptake in lung parenchyma would increase the diagnostic yield of the biopsy procedure. Biopsies were obtained from the areas showing parenchymal uptake on the ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.82.1.7

    authors: Ackart RS,Munzel TL,Rodriguez JJ,Donlan CJ,Klayton RJ,Foreman DR

    更新日期:1982-07-01 00:00:00

  • Acute respiratory and cardiovascular effects of inhaled ketanserin in chronic obstructive pulmonary disease. A comparative study with intravenously administered ketanserin.

    abstract::In a double-blind, crossover study, nebulized ketanserin, a 5-HT2 receptor antagonist, and a placebo were given to eight patients with moderate to severe nonasthmatic COPD. Intravenous ketanserin had rapid onset of action and induced a longer lasting bronchial response than inhaled ketanserin. These results confirm th...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.97.4.901

    authors: Cazzola M,Guidetti E,Sepe J,Assogna G,Lucchetti G,Santangelo G,D'Amato G

    更新日期:1990-04-01 00:00:00

  • COPD: exacerbation.

    abstract::A renewed interest in the clinical and pathogenic aspects of COPD exacerbation is timely in view of national and global COPD initiatives. The three big problems regarding COPD continue to be the following: prevention of the disease; slowing progression of the disease once diagnosis has been established; and prevention...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.117.5_suppl_2.376s

    authors: Voelkel NF,Tuder R

    更新日期:2000-05-01 00:00:00

  • Late carmustine lung fibrosis. Age at treatment may influence severity and survival.

    abstract::Previously, we have reported in 1990 that 35% of carmustine treated patients (6 of 17) who survived childhood brain tumors died of pulmonary fibrosis between 2 and 13 years after treatment. In addition, 8 patients studied in 1989 (13 to 17 years post treatment), had physiologic and biopsy or radiologic evidence of pul...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.107.5.1355

    authors: O'Driscoll BR,Kalra S,Gattamaneni HR,Woodcock AA

    更新日期:1995-05-01 00:00:00

  • Pulmonary abnormalities on high-resolution CT demonstrate more rapid decline than FEV1 in adults with cystic fibrosis.

    abstract:BACKGROUND:FEV1 may remain stable while high-resolution CT (HRCT) appearances deteriorate in children with cystic fibrosis (CF). However, spirometry results commonly decline in older age groups. OBJECTIVES:To compare the rate of decline in HRCT abnormalities and spirometry results over time in an adult cohort with CF....

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.130.5.1424

    authors: Judge EP,Dodd JD,Masterson JB,Gallagher CG

    更新日期:2006-11-01 00:00:00

  • Noninvasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS.

    abstract:BACKGROUND:There is increasing support for the use of noninvasive positive pressure ventilation (NPPV) in the treatment of patients with acute respiratory failure. Highest success rates are recorded in patients with exacerbation of COPD, particularly in patients presenting primarily with hypercarbic respiratory failure...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.115.1.173

    authors: Rocker GM,Mackenzie MG,Williams B,Logan PM

    更新日期:1999-01-01 00:00:00

  • Cross-sectional echocardiographic observations on the mechanism of preservation of the opening snap in calcific mitral stenosis.

    abstract::Cross-sectional echocardiography (CSE) was performed on 19 patients with mitral stenosis (MS). Nine patients (group 1) had little or no mitral valve (MV) calcification; ten patients (group 2) had heavy MV calcification. An opening snap was present in each of the patients in group 1. Of the group 2 patients, five (grou...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.78.6.822

    authors: Chandraratna PA,Aronow WS,Lurie M

    更新日期:1980-12-01 00:00:00

  • Recovery of the ventilatory and upper airway muscles and exercise performance after type A botulism.

    abstract::We studied six patients with type A botulism to determine the degree of initial respiratory compromise and to quantitate the time course and extent of recovery of the ventilatory and upper airway muscles and exercise performance. The VM weakness was identified in all patients early after botulism. Upper airway muscle ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.3.620

    authors: Wilcox PG,Morrison NJ,Pardy RL

    更新日期:1990-09-01 00:00:00

  • Use of pulmonary function tests in the management of sarcoidosis.

    abstract::The literature on pulmonary function testing in sarcoidosis is critically reviewed. The results indicate that pulmonary function tests are not a reliable means for detecting the presence of parenchymal sarcoidosis, nor do they provide an accurate estimate of the extent of parenchymal disease. There are at present no k...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.78.4.640

    authors: Winterbauer RH,Hutchinson JF

    更新日期:1980-10-01 00:00:00

  • Elimination of the left atrial appendage to prevent stroke or embolism? Anatomic, physiologic, and pathophysiologic considerations.

    abstract::The "elimination" of the left atrial appendage (LAA) seems to be an attractive alternative to oral anticoagulation in the treatment of atrial fibrillation, especially in patients with contraindications to oral anticoagulation therapy. The LAA, however, plays an important role in the maintenance and regulation of the c...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.124.6.2356

    authors: Stöllberger C,Schneider B,Finsterer J

    更新日期:2003-12-01 00:00:00

  • Determinants of exhaled nitric oxide in chronic rhinosinusitis.

    abstract:BACKGROUND:Chronic rhinosinusitis (CRS) has been reported to be associated with increased values of exhaled nitric oxide (ENO), which could not be entirely explained by the association between CRS and asthma. The aim of this study was to investigate the variables associated with increased ENO in patients with CRS. MET...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.09-0667

    authors: Guida G,Rolla G,Badiu I,Marsico P,Pizzimenti S,Bommarito L,De Stefani A,Usai A,Bugiani M,Malinovschi A,Bucca C,Heffler E

    更新日期:2010-03-01 00:00:00

  • Pulmonary hypertension and right heart failure in patients with beta-thalassemia intermedia.

    abstract::We analyzed seven patients with beta-thalassemia intermedia presenting with congestive heart failure secondary to pulmonary hypertension. This condition has been recognized only recently as part of the clinical spectrum of beta-thalassemia. Our group of patients included two men and five women with the clinical pictur...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.107.1.50

    authors: Aessopos A,Stamatelos G,Skoumas V,Vassilopoulos G,Mantzourani M,Loukopoulos D

    更新日期:1995-01-01 00:00:00

  • Formes frustes of Churg-Strauss syndrome.

    abstract::We report 4 cases of Churg-Strauss syndrome (CSS) that occurred in patients being treated with corticosteroids for a diagnosis of asthma. One patient had asthma, eosinophilia, and eosinophilic lymphadenopathy that regressed with higher doses of corticosteroids. The second patient had both eosinophilic tissue infiltrat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.108.2.320

    authors: Churg A,Brallas M,Cronin SR,Churg J

    更新日期:1995-08-01 00:00:00

  • Integration of clinical and hemodynamic parameters in the prediction of long-term survival in patients with pulmonary arterial hypertension.

    abstract:BACKGROUND:Current management guidelines for pulmonary arterial hypertension (PAH) recommend a treatment choice based primarily on World Health Organization (WHO) functional class. This study was designed to assess how the incorporation of readily obtained clinical and test-based information may significantly improve t...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.10-1293

    authors: Kane GC,Maradit-Kremers H,Slusser JP,Scott CG,Frantz RP,McGoon MD

    更新日期:2011-06-01 00:00:00

  • Persistence of airway obstruction and hyperresponsiveness in subjects with asthma remission.

    abstract::This study was designed to determine if there is residual airflow obstruction and/or airway hyperresponsiveness in adults with symptomatic asthma remission, and if age at remission or its duration influence these parameters. We studied 30 subjects, (20 men, 10 women, 28 atopics, aged 18 to 61 years; mean, 32 years) wi...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.4.1024

    authors: Boulet LP,Turcotte H,Brochu A

    更新日期:1994-04-01 00:00:00

  • Simplified prediction rule for prognosis of patients with severe community-acquired pneumonia in ICUs.

    abstract:STUDY OBJECTIVES:To develop a simplified prognostic prediction rule for patients admitted to ICUs for severe community-acquired pneumonia (CAP). SETTING:Six ICUs in the north of France. PATIENTS:Five hundred five patients admitted to ICUs over a 9-year period (from 1987 to 1995) for severe CAP. INTERVENTIONS:Retrosp...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.116.1.157

    authors: Leroy O,Devos P,Guery B,Georges H,Vandenbussche C,Coffinier C,Thévenin D,Beaucaire G

    更新日期:1999-07-01 00:00:00

  • Childhood obstructive sleep-disordered breathing: a clinical update and discussion of technological innovations and challenges.

    abstract::Childhood sleep-disordered breathing (SDB) has been known to be associated with health and cognitive impacts for more than a century, and yet our understanding of this disorder is in its infancy. Neuropsychological consequences in children with snoring or subtle breathing disturbances not meeting the traditional defin...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.06-2827

    authors: Halbower AC,Ishman SL,McGinley BM

    更新日期:2007-12-01 00:00:00

  • A 62-Year-Old Woman With Diffuse Myalgias, Fatigue, and Shortness of Breath.

    abstract:CASE PRESENTATION:A 62-year-old woman with a history of partially treated Graves disease and hypertension presented with approximately 3 weeks of worsening fatigue, lower extremity myalgias, and shortness of breath. Her medical history included a thyroid radiofrequency ablation several years earlier. Following the abla...

    journal_title:Chest

    pub_type:

    doi:10.1016/j.chest.2019.09.041

    authors: Park BD,Lyn-Kew K,Granchelli A,Mehta A

    更新日期:2020-03-01 00:00:00

  • Positron emission tomography in the staging of small-cell lung cancer : a preliminary study.

    abstract:STUDY OBJECTIVES:Small-cell lung cancer (SCLC) has an unfavorable prognosis, especially when the disease is extensive at presentation. Accurate staging procedures are therefore needed for treatment planning. Positron emission tomography (PET) is a modern noninvasive imaging technique, the value of which for the staging...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.119.3.950

    authors: Hauber HP,Bohuslavizki KH,Lund CH,Fritscher-Ravens A,Meyer A,Pforte A

    更新日期:2001-03-01 00:00:00

  • Effect of acute arteriolar vasodilation on capacitance and resistance in pulmonary arterial hypertension.

    abstract:BACKGROUND:Pulmonary vascular capacitance (PVC) is reduced in pulmonary arterial hypertension (PAH). In normal lung, PVC is largely a function of vascular compliance. In PAH, increased pulmonary vascular resistance (PVR) arises from the arterioles. PVR and PVC share pressure and volume variables. The dependency between...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-1461

    authors: Newman JH,Brittain EL,Robbins IM,Hemnes AR

    更新日期:2015-04-01 00:00:00

  • Brain natriuretic peptide in the management of heart failure: the versatile neurohormone.

    abstract::Brain natriuretic peptide (BNP), also called B-type natriuretic peptide, is a member of a family of structurally related hormones, the natriuretic peptides. Current data suggest that measurement of BNP plasma concentrations is a useful tool in the diagnosis of acute heart failure in patients presenting to an emergency...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.125.2.652

    authors: de Denus S,Pharand C,Williamson DR

    更新日期:2004-02-01 00:00:00

  • Prediction of postoperative pulmonary function with the lateral position test. A prospective study.

    abstract::Ten patients undergoing pneumonectomy were evaluated with the lateral position test (LPT) in addition to routine pulmonary function tests (PFTs). On the basis of the percentage of ventilation estimated to be contributed by each lung on LPT, predictions were made for expected values for each patient's post-pneumonectom...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.77.1.24

    authors: Walkup RH,Vossel LF,Griffin JP,Proctor RJ

    更新日期:1980-01-01 00:00:00