Pulmonary Vascular Morphology as an Imaging Biomarker in Chronic Thromboembolic Pulmonary Hypertension
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Título: | Pulmonary Vascular Morphology as an Imaging Biomarker in Chronic Thromboembolic Pulmonary Hypertension |
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Autor/es: | Rahaghi, Farbod N. | Ross, James C. | Agarwal, M. | González, Germán | Come, C.E. | Díaz, Alejandro | Vegas-Sánchez-Ferrero, Gonzalo | Hunsaker, A. | San José Estépar, Raúl | Waxman, A.B. | Washko, George R. |
Grupo/s de investigación o GITE: | Robótica y Visión Tridimensional (RoViT) |
Centro, Departamento o Servicio: | Universidad de Alicante. Departamento de Ciencia de la Computación e Inteligencia Artificial |
Palabras clave: | Chronic thromboembolic pulmonary hypertension | Computed tomography | Arterial | Tortuosity |
Fecha de publicación: | 1-mar-2016 |
Editor: | SAGE Publications |
Cita bibliográfica: | Pulmonary Circulation. 2016, 6(1): 70-81. https://doi.org/10.1086/685081 |
Resumen: | Patients with chronic thromboembolic pulmonary hypertension (CTEPH) have morphologic changes to the pulmonary vasculature. These include pruning of the distal vessels, dilation of the proximal vessels, and increased vascular tortuosity. Advances in image processing and computer vision enable objective detection and quantification of these processes in clinically acquired computed tomographic (CT) scans. Three-dimensional reconstructions of the pulmonary vasculature were created from the CT angiograms of 18 patients with CTEPH diagnosed using imaging and hemodynamics as well as 15 control patients referred to our Dyspnea Clinic and found to have no evidence of pulmonary vascular disease. Compared to controls, CTEPH patients exhibited greater pruning of the distal vasculature (median density of small-vessel volume: 2.7 [interquartile range (IQR): 2.5–3.0] vs. 3.2 [3.0–3.8]; P = 0.008), greater dilation of proximal arteries (median fraction of blood in large arteries: 0.35 [IQR: 0.30–0.41] vs. 0.23 [0.21–0.31]; P = 0.0005), and increased tortuosity in the pulmonary arterial tree (median: 4.92% [IQR: 4.85%–5.21%] vs. 4.63% [4.39%–4.92%]; P = 0.004). CTEPH was not associated with dilation of proximal veins or increased tortuosity in the venous system. Distal pruning of the vasculature was correlated with the cardiac index (R = 0.51, P = 0.04). Quantitative models derived from CT scans can be used to measure changes in vascular morphology previously described subjectively in CTEPH. These measurements are also correlated with invasive metrics of pulmonary hemodynamics, suggesting that they may be used to assess disease severity. Further work in a larger cohort may enable the use of such measures as a biomarker for diagnostic, phenotyping, and prognostic purposes. |
Patrocinador/es: | Authors in this study were supported by National Heart, Lung, and Blood Institute grants 5T32HL007633 (FNR) and 1R01HL116931 (RSJE and GRW). |
URI: | http://hdl.handle.net/10045/138545 |
ISSN: | 2045-8932 (Print) | 2045-8940 (Online) |
DOI: | 10.1086/685081 |
Idioma: | eng |
Tipo: | info:eu-repo/semantics/article |
Derechos: | © 2016 by the Pulmonary Vascular Research Institute |
Revisión científica: | si |
Versión del editor: | https://doi.org/10.1086/685081 |
Aparece en las colecciones: | INV - RoViT - Artículos de Revistas |
Archivos en este ítem:
Archivo | Descripción | Tamaño | Formato | |
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Rahaghi_etal_2016_PulmonaryCirculation_final.pdf | Versión final (acceso restringido) | 11,27 MB | Adobe PDF | Abrir Solicitar una copia |
Rahaghi_etal_2016_PulmonaryCirculation_accepted.pdf | Accepted Manuscript (acceso abierto) | 1,39 MB | Adobe PDF | Abrir Vista previa |
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