Highlights
- •The prevalence of MPA ≥ 34 mm and MPA:AA ≥ 1.0 was 4.2% and 6.9%, respectively.
- •BMI was significantly associated with both having MPA ≥ 34 mm (OR = 1.07, p < 0.0001) and MPA:AA ≥ 1.0 (OR = 1.04, p = 0.003) after adjusting for other covariates.
- •No significant association between emphysema on CT and an increase in MPA or MPA:AA was found in this study.
- •When the MPA ≥ 34 mm or MPA:AA ≥ 1.0, further evaluation for possible PH is recommended.
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.
Keywords
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Article info
Publication history
Published online: January 29, 2020
Accepted:
November 20,
2019
Received in revised form:
November 15,
2019
Received:
September 13,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
