Why the study?
Can CTPA measurements of left atrium size and PA/aorta ratio accurately detect diastolic dysfunction and pulmonary hypertension compared to echocardiography?
Can CTPA measurements of left atrium size and PA/aorta ratio accurately detect diastolic dysfunction and pulmonary hypertension compared to echocardiography?
CTPA measurements of left atrial size and PA/aorta ratio correlate strongly with echocardiography and can be used to opportunistically screen for diastolic dysfunction and pulmonary hypertension.
CTPA LA diameters correlated with echo DD; leaves open clinical utility for DD detection pending prospective validation.
PURPOSE: Left atrium (LA) enlargement on echocardiography may be an indicator of diastolic dysfunction (DD). It is not well known if computed tomography pulmonary angiography (CTPA) can detect DD. METHODS: A total of 127 patients who underwent both CTPA and echo within 48 hours were analyzed retrospectively. Left atrium diameters from CTPA were correlated with echo and evaluated against degrees of DD. Computed tomography pulmonary angiography pulmonary artery (PA)/aorta ratio was analyzed as a tool to detect pulmonary hypertension. RESULTS: There were 42% of patients who had DD. There was a strong correlation between LA size on CTPA and echo (r = 0.78). An LA greater than 4.0 cm gave a sensitivity of 68.1% and specificity of 73.9% for DD detection. A PA/aorta cutoff greater than 0.84 yielded a sensitivity of 84% and specificity of 33% for pulmonary hypertension. CONCLUSIONS: Computed tomography pulmonary angiography measurements of LA and PA/aorta ratio correlate strongly with equivalent findings on echo. We suggest that LA and PA/aorta measurements be included on chest CTPA reports.
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Lick et al. (2017) studied this question.
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