David Steiger1, Dan Han2, Rowena Yip3, Kunwei Li4, Xiangmeng Chen5, Li Liu6, Jiayi Liu7, Teng Ma8, Faisal Siddiqi1, David F Yankelevitz3, Claudia I Henschke9. 1. Division of Pulmonary Medicine, Icahn School of Medicine, New York, NY, United States of America. 2. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China. 3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America. 4. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. 5. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Jiangmen Central Hospital, Jiangmen, China. 6. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Diagnostic Radiology, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Chaoyang District, Beijing, China. 7. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing, China. 8. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Radiology, Tong Ren Hospital, Capital Medical University, Dongcheng District, Beijing, China. 9. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America. Electronic address: Claudia.Henschke@mountsinai.org.
Abstract
OBJECTIVES: Pulmonary hypertension (PH) is a progressive, potentially fatal disease, difficult to diagnose early due to non-specific nature of symptoms. PH is associated with increased morbidity and death in many respiratory and cardiac disorders, and with all-cause mortality, independent of age and cardiopulmonary disease. The main pulmonary artery diameter (MPA), and ratio of MPA to adjacent ascending aorta (AA), MPA:AA, on Chest CT are strong indicators of suspected PH. Our goal was to determine the prevalence of abnormally high values of these indicators of PH in asymptomatic low-dose CT (LDCT) screening participants at risk of lung cancer, and determine the associated risk factors. METHODS: We reviewed consecutive baseline LDCT scans of 1949 smokers in an IRB-approved study. We measured the MPA and AA diameter and calculated MPA:AA ratio. We defined abnormally high values as being more than two standard deviations above the average (MPA ≥ 34 mm and MPA:AA ≥ 1.0). Regression analyses were used to identify risk factors and CT findings of participants associated with high values. RESULTS: The prevalence of MPA ≥ 34 mm and MPA:AA ≥ 1.0 was 4.2% and 6.9%, respectively. Multivariable regression demonstrated that BMI was a significant risk factor, both for MPA ≥ 34 mm (OR = 1.07, p < 0.0001) and MPA:AA ≥ 1.0 (OR = 1.04, p = 0.003). Emphysema was significant in the univariate but not in the multivariate analysis. CONCLUSIONS: We determined that the possible prevalence of PH as defined by abnormally high values of MPA and of MPA:AA was greater than previously described in the general population and that pulmonary consultation be recommended for these participants, in view of the significance of PH.
OBJECTIVES:Pulmonary hypertension (PH) is a progressive, potentially fatal disease, difficult to diagnose early due to non-specific nature of symptoms. PH is associated with increased morbidity and death in many respiratory and cardiac disorders, and with all-cause mortality, independent of age and cardiopulmonary disease. The main pulmonary artery diameter (MPA), and ratio of MPA to adjacent ascending aorta (AA), MPA:AA, on Chest CT are strong indicators of suspected PH. Our goal was to determine the prevalence of abnormally high values of these indicators of PH in asymptomatic low-dose CT (LDCT) screening participants at risk of lung cancer, and determine the associated risk factors. METHODS: We reviewed consecutive baseline LDCT scans of 1949 smokers in an IRB-approved study. We measured the MPA and AA diameter and calculated MPA:AA ratio. We defined abnormally high values as being more than two standard deviations above the average (MPA ≥ 34 mm and MPA:AA ≥ 1.0). Regression analyses were used to identify risk factors and CT findings of participants associated with high values. RESULTS: The prevalence of MPA ≥ 34 mm and MPA:AA ≥ 1.0 was 4.2% and 6.9%, respectively. Multivariable regression demonstrated that BMI was a significant risk factor, both for MPA ≥ 34 mm (OR = 1.07, p < 0.0001) and MPA:AA ≥ 1.0 (OR = 1.04, p = 0.003). Emphysema was significant in the univariate but not in the multivariate analysis. CONCLUSIONS: We determined that the possible prevalence of PH as defined by abnormally high values of MPA and of MPA:AA was greater than previously described in the general population and that pulmonary consultation be recommended for these participants, in view of the significance of PH.
Authors: Marta Marin-Oto; Luis M Seijo; Miguel Divo; Gorka Bastarrika; Ana Ezponda; Marta Calvo; Javier J Zulueta; Guillermo Gallardo; Elena Cabezas; German Peces-Barba; Maria T Pérez-Warnisher; Jose M Marín; Bartolomé R Celli; Ciro Casanova; Juan P De-Torres Journal: J Clin Med Date: 2021-01-30 Impact factor: 4.241
Authors: Rowena Yip; Artit Jirapatnakul; Minxia Hu; Xiangmeng Chen; Dan Han; Teng Ma; Yeqing Zhu; Mary M Salvatore; Laurie R Margolies; David F Yankelevitz; Claudia I Henschke Journal: Transl Lung Cancer Res Date: 2021-02