Abstract:
PURPOSE:Right ventricular myocardial (RVM) fibrosis may be a significant indicator of prognosis in pulmonary hypertension (PH). To detect the presence of RVM fibrosis in PH subjects, we employed ECG gated 320-slice CT. METHODS:62 confirmed PH subjects (16 males; 55±16years; 45 chronic thromboembolic PH (CTEPH) who underwent conventional non-surgical medical therapy; and 17 pulmonary arterial hypertension (PAH)) underwent ECG-gated 320-slice CT. On CT, RV fibrosis was defined as contrast defect in the early phase and conversely abnormal enhancement in the late phase. RESULTS:RVM fibrosis was observed in 14 subjects (23%) on CT (CTEPH 22%; PAH 29%; P=0.91). CT attenuation of RVM in the late phase was significantly greater in subjects with RVM fibrosis than in those without (P=0.025). ROC curves of CT attenuation of RVM in the early and late phase, and ratio of CT attenuation of RVM in the early phase/late phase showed AUCs of 0.55, 0.70, and 0.65, respectively. The best cutoff points of 79.5 HU (sensitivity of 50% and specificity of 69% for CT attenuation of RVM in the early phase, P=0.59), 99.5 HU (sensitivity of 50% and specificity of 88% for CT attenuation of RVM in the late phase, P=0.025), and 1.416 (sensitivity of 29% and specificity of 94% for ratio of CT attenuation of RVM in the early phase/late phase, P=0.092) were used to distinguish subjects±RVM fibrosis. CONCLUSION:Quantitative-measurement of CT attenuation of RVM in the late phase may be able to detect presence of RVM fibrosis in PH subjects.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Ozawa K,Funabashi N,Takaoka H,Tanabe N,Tatsumi K,Kobayashi Ydoi
10.1016/j.ijcard.2016.11.131subject
Has Abstractpub_date
2017-02-01 00:00:00pages
165-168eissn
0167-5273issn
1874-1754pii
S0167-5273(16)33591-4journal_volume
228pub_type
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