open access

Vol 77, No 1 (2009)
ORIGINAL PAPERS
Published online: 2008-12-19
Submitted: 2013-02-22
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Abnormalities in high-resolution computed tomography of the lungs in patients with idiopathic pulmonary arterial hypertension - correlation with hemodynamic parameters and prognostic significance

Aneta Kacprzak, Monika Szturmowicz, Barbara Burakowska, Anna Fijałkowska, Marcin Kurzyna, Maria Wieteska, Michał Florczyk, Joanna Żyłkowska, Monika Franczuk, Stefan Wesołowski, Adam Torbicki
Pneumonol Alergol Pol 2009;77(1):23-30.

open access

Vol 77, No 1 (2009)
ORIGINAL PAPERS
Published online: 2008-12-19
Submitted: 2013-02-22

Abstract


Introduction: The risk stratification in idiopathic pulmonary arterial hypertension (IPAH) patients is currently based on haemodynamic and functional parameters as well as serum biomarker concentrations. Until now the importance of changes appearing in high-resolution computed tomography (HRCT) of the lungs of patients with IPAH has not been investigated.
Material and methods: Lung HRCT scans were analysed retrospectively in 48 IPAH patients (patients): 37 women, 11 men, mean age 41 ± 15 years.
Results: Focal ground-glass opacifications (FGG) were found in 12 patients (25%), and centrilobular nodules (CN) were found in 8 patients (17%). In the remaining 58% of patients HRCT revealed no changes (N). Significantly lower stroke volume was found in the CN group (41.0 ± 8.5 ml) compared to 60.8 ± 15.1 ml in the FGG group and 58.1 ± 18.0 ml in the N group (p = 0.03). Right atrial pressure was significantly higher in the CN group (12.2 ± 4.86 mm Hg) than in the FGG group (6.9 ± 3.9 mm Hg) and the N group (7.6 ± 5.3 mm Hg), p = 0.047. The presence of nodules was combined with considerably increased risk of death, both in univariate analysis (HR 5.35, 95% CI: 1.16-24.7, p = 0.03) and in multivariate analysis (HR 6.98, 95% CI: 1.41-34.59, p = 0.02). Ground-glass opacifications correlated neither with haemodynamic nor functional indexes, and were of no prognostic significance.
Conclusions: The presence of centrilobular nodules in lung HRCT scans of IPAH patients was combined with more severe haemodynamic compromise and was an independent negative prognostic indicator.

Abstract


Introduction: The risk stratification in idiopathic pulmonary arterial hypertension (IPAH) patients is currently based on haemodynamic and functional parameters as well as serum biomarker concentrations. Until now the importance of changes appearing in high-resolution computed tomography (HRCT) of the lungs of patients with IPAH has not been investigated.
Material and methods: Lung HRCT scans were analysed retrospectively in 48 IPAH patients (patients): 37 women, 11 men, mean age 41 ± 15 years.
Results: Focal ground-glass opacifications (FGG) were found in 12 patients (25%), and centrilobular nodules (CN) were found in 8 patients (17%). In the remaining 58% of patients HRCT revealed no changes (N). Significantly lower stroke volume was found in the CN group (41.0 ± 8.5 ml) compared to 60.8 ± 15.1 ml in the FGG group and 58.1 ± 18.0 ml in the N group (p = 0.03). Right atrial pressure was significantly higher in the CN group (12.2 ± 4.86 mm Hg) than in the FGG group (6.9 ± 3.9 mm Hg) and the N group (7.6 ± 5.3 mm Hg), p = 0.047. The presence of nodules was combined with considerably increased risk of death, both in univariate analysis (HR 5.35, 95% CI: 1.16-24.7, p = 0.03) and in multivariate analysis (HR 6.98, 95% CI: 1.41-34.59, p = 0.02). Ground-glass opacifications correlated neither with haemodynamic nor functional indexes, and were of no prognostic significance.
Conclusions: The presence of centrilobular nodules in lung HRCT scans of IPAH patients was combined with more severe haemodynamic compromise and was an independent negative prognostic indicator.
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Keywords

idiopathic pulmonary arterial hypertension; high resolution computed tomography; prognosis

About this article
Title

Abnormalities in high-resolution computed tomography of the lungs in patients with idiopathic pulmonary arterial hypertension - correlation with hemodynamic parameters and prognostic significance

Journal

Advances in Respiratory Medicine

Issue

Vol 77, No 1 (2009)

Pages

23-30

Published online

2008-12-19

Bibliographic record

Pneumonol Alergol Pol 2009;77(1):23-30.

Keywords

idiopathic pulmonary arterial hypertension
high resolution computed tomography
prognosis

Authors

Aneta Kacprzak
Monika Szturmowicz
Barbara Burakowska
Anna Fijałkowska
Marcin Kurzyna
Maria Wieteska
Michał Florczyk
Joanna Żyłkowska
Monika Franczuk
Stefan Wesołowski
Adam Torbicki

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