Optical coherence tomography for hypertensive pulmonary vasculature

详细信息    查看全文

• 作者：Xin Jiang^a ; ¹ ; Fu-Hua Peng^a ; ¹ ; Qian-Qian Liu^a ; ¹ ; Qin-Hua Zhao^b ; Jing He^b ; Rong Jiang^b ; Lan Wang^b ; Xi-Qi Xu^a ; Jing-Hui LI^a ; Ramin Ebrahimi^c ; Zhi-Cheng Jing^a ; ^b ; ^{jingzhicheng@vip.163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：OCT ; optical coherence tomography ; mPAP ; mean pulmonary artery pressure ; sPAP ; systolic pulmonary artery pressure ; RV ; right ventricle ; PAH ; pulmonary artery hypertension ; CTEPH ; chronic thromboembolic pulmonary hypertension ; PA ; pulmonary artery ; SV ; stroke volume ; CO ; cardiac output ; RHC ; right heart catheterization
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 November 2016
• 年：2016
• 卷：222
• 期：Complete
• 页码：494-498
• 全文大小：463 K

文摘

Optical coherence tomography (OCT) is an intravascular imaging modality capable of providing in situ images of tissues at near histologic resolution. In this study we examine the utility of OCT in identifying vascular changes related to pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

Methods and results

OCT of four different distal pulmonary arteries was performed during right heart catheterization in 87 patients, 64 patients with PAH and 23 patients with CTEPH. The mean luminal diameter measured by OCT for all patients was 2.26 mm. Intimal thickening was significantly increased in all PAH patients (0.26 ± 0.05 mm in idiopathic PAH, 0.24 ± 0.03 mm in connective tissue disease related PAH, 0.26 ± 0.06 mm in congenital heart disease related PAH and 0.22 ± 0.04 mm in CTEPH, respectively) compared with controls (0.13 ± 0.03 mm) (all p < 0.05). An intimal thickness of ≥ 0.176 mm had a 91% positive predictive value for pulmonary hypertension. The anatomic abnormalities revealed by OCT tended to be severe in the idiopathic PAH group and mild in the CTEPH group. Signs of intravascular webs were found in 60.9% of CTEPH patients, but no other patients. Intimal thickness was moderately correlated with pulmonary arterial pressure and pulmonary vascular resistance (r = 0.423 and 0.439, respectively, p < 0.001).

Conclusions

OCT provides important information for assessment of pulmonary arterial remodeling in patients with PAH and improves diagnostic capability of angiographically undetected distal-thrombotic lesions in patients with CTEPH.