Сomputed tomography in assessing the severity of patients with chronic thromboembolic pulmonary hypertension

Objective. To evaluate the role of computed tomography in the assessment of chronic thromboembolic pulmonary hypertension (CTEPH) severity. Design and methods. We included 41 patients. Chest dual-energy CT-computed tomographic angiography was performed according to the standard protocol and in some cases Dual Energy mode was used. The patients were divided into 2 groups: with proximal and distal types of pulmonary artery lesions. Results. Quanadli index and Score index showed a significant negative correlation with the value of cardiac output (CO) (r = –0,591, p < 0,05; r = –0,531, p < 0,001, respectively), mixed venous blood saturation (SvO2) (r = –0,457, p = 0,065; r = –0,595, p < 0,001, respectively). For the Score index, significant negative correlations were established with both the CO value: r = –0,531, p < 0,001, the SvO2 r = –0,595, p < 0,001, and with the N-terminal pro-B type natriuretic peptide (NTproBNP) value (r = –0,537, p = 0,003). Correlations are also found in the analysis within the compared groups. The Quanadli index correlated with the mean pressure in the pulmonary artery in the group with the proximal type of lesion (r = 0,825, p = 0,012). Pulmonary artery aneurysms were detected in 39 % (n = 16) patients. There was a positive correlation between the presence of a pulmonary artery aneurysm and the functional class of CTEPH (r = 0,526, p = 0,007) in patients with the distal lesion. Conclusions. Quanadli and Score indices are promising tools for CTEPH severity assessment.

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