PMID- 37423613
OWN - NLM
STAT- MEDLINE
DCOM- 20240422
LR  - 20240422
IS  - 1536-0237 (Electronic)
IS  - 0883-5993 (Linking)
VI  - 39
IP  - 3
DP  - 2024 May 1
TI  - A Novel Dual Energy Computed Tomography Score Correlates With Postoperative 
      Outcomes in Chronic Thromboembolic Pulmonary Hypertension.
PG  - 178-184
LID - 10.1097/RTI.0000000000000724 [doi]
AB  - PURPOSE: To compare dual-energy computed tomography (DECT) based qualitative and 
      quantitative parameters in chronic thromboembolic pulmonary hypertension with 
      various postoperative primary and secondary endpoints. MATERIALS AND METHODS: 
      This was a retrospective analysis of 64 patients with chronic thromboembolic 
      pulmonary hypertension who underwent DECT. First, a clot score was calculated by 
      assigning the following score: pulmonary trunk-5, each main pulmonary artery-4, 
      each lobar-3, each segmental-2, and subsegmental-1 per lobe; the sum total was 
      then calculated. The perfusion defect (PD) score was calculated by assigning 1 
      point to each segmental PD. The combined score was calculated by adding clot and 
      PD scores. For quantitative evaluation, we calculated perfused blood volume (PBV) 
      (%) of each lung and the sum of both lungs. Primary endpoints included testing 
      association between combined score and total PBV with change in mean pulmonary 
      arterial pressure ([mPAP], change calculated as preop minus postop values). 
      Secondary endpoints included explorative analysis of the correlation between 
      combined score and PBV with change in preoperative and postoperative pulmonary 
      vascular resistance, change in preoperative 6-minute walk distance (6MWD), and 
      immediate postoperative complications such as reperfusion edema, ECMO placement, 
      stroke, death and mechanical ventilation for more than 48 hours, all within 1 
      month of surgery. RESULTS: Higher combined scores were associated with larger 
      decreases in mPAP ( =0.27, P =0.036). On average, the decrease in mPAP (pre 
      mPAP-post mPAP) increased by 2.2 mm Hg (95% CI: -0.6, 5.0) with each 10 unit 
      increase in combined score. The correlation between total PBV and change in mPAP 
      was small and not statistically significant. During an exploratory analysis, 
      higher combined scores were associated with larger increases in 6MWD at 6 months 
      postprocedure ( =0.55, P =0.002). CONCLUSION: Calculation of DECT-based combined 
      score offers potential in the evaluation of hemodynamic response to surgery. This 
      response can also be objectively quantified.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Renapurkar, Rahul D
AU  - Renapurkar RD
AD  - Section of Thoracic Imaging, Imaging Institute.
FAU - Bullen, Jennifer
AU  - Bullen J
AD  - Quantitative Health Sciences.
FAU - Rizk, Alain
AU  - Rizk A
AD  - Section of Thoracic Imaging, Imaging Institute.
FAU - Abozeed, Mostafa
AU  - Abozeed M
AD  - Section of Thoracic Imaging, Imaging Institute.
FAU - Karim, Wadih
AU  - Karim W
AD  - Section of Thoracic Imaging, Imaging Institute.
FAU - Bin Saeedan, Mnahi
AU  - Bin Saeedan M
AD  - Section of Thoracic Imaging, Imaging Institute.
FAU - Tong, Michael Z
AU  - Tong MZ
AD  - Department of Cardiothoracic Surgery.
FAU - Heresi, Gustavo A
AU  - Heresi GA
AD  - Department of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, 
      OH.
LA  - eng
PT  - Journal Article
DEP - 20230707
PL  - United States
TA  - J Thorac Imaging
JT  - Journal of thoracic imaging
JID - 8606160
SB  - IM
MH  - Humans
MH  - *Hypertension, Pulmonary/complications/diagnostic imaging
MH  - *Pulmonary Embolism/complications/diagnostic imaging/surgery
MH  - Tomography, X-Ray Computed/methods
MH  - Retrospective Studies
MH  - Chronic Disease
COIS- The authors declare no conflicts of interest.
EDAT- 2023/07/10 00:41
MHDA- 2024/04/22 06:44
CRDT- 2023/07/09 20:22
PHST- 2024/04/22 06:44 [medline]
PHST- 2023/07/10 00:41 [pubmed]
PHST- 2023/07/09 20:22 [entrez]
AID - 00005382-990000000-00077 [pii]
AID - 10.1097/RTI.0000000000000724 [doi]
PST - ppublish
SO  - J Thorac Imaging. 2024 May 1;39(3):178-184. doi: 10.1097/RTI.0000000000000724. 
      Epub 2023 Jul 7.