Explore The Value Of Pulmonary Artery Diameter To Aorta Diameter Ratio In The Diagnosis Of Pulmonary Hypertension

Objective: Analysis of the correlations compared with the pulmonary arterysystolic pressure(PASP) to main pulmonary artery diameter(MPAD)、main pulmonaryartery and aorta diameter ratio(MPAD/MAD)，as well as the statistical difference ofMPAD、 MPAD/MAD in different types of patients with pulmonary hyperten-sion,explore the value of MPAD and MPAD/MAD in the diagnosis of pulmonaryhypertension.Methods:(1)87patients with pulmonary hypertension diagnosed byechocardiography from the respiratory department of First Affiliated Hospital ofDalian Medical University since January2008to December2013are retrospectivelyanalyizes, including58cases of patients with chronic obstructive pulmonary diseasethat correspond the " chronic obstructive pulmonary disease treatment guidelines"(2013revised edition) formulate by Chronic Obstructive Pulmonary DiseaseCommittee,Respiratory Society,Chinese Medical Association. Set group A:chronicobstructive pulmonary disease secondary to pulmonary hypertension; Another29caseshave clinical manifestations of chronic pulmonary hypertension, when takingpulmonary artery angiography (CTPA) check or pulmonary ventilation/perfusionscintigraphy examination revealed chronic pulmonary thrombosis, set to group B:chronic thromboembolic pulmonary hypertension;Meanwhile,collecting87normal cases,this group is setting to C: normal control group.(2)Measuring the tricuspidregurgitation peak velocity by echocardiography,using the formula PASP (pulmonaryartery systolic pressure)=4×TR2+RAP (right atrial pressure, usually set to10mmHg)calculated pulmonary artery systolic pressure,classificating pulmonary hypertensionrefered to the2009European Society of Cardiology (ESC) guidelines.(3) three groupsof patients underwent computed tomographic, Selecting mediastinal window tomeasure MPAD and MAD, calculated MPAD/MAD.(4)Use SPSS13.0statisticalsoftware to calculate the relevant statistics.Results: There were37males and21females in group A, while the mean age74years old (47-88years old);The pulmonary hypertension grading of pulmonaryhypertension secondary to COPD:mild47,moderate8and severe3; Group B including14males and15females, mean age63years old (35-78years old);The pulmonaryhypertension grading of chronic thromboembolic pulmonary hypertension:mild5,moderate8and severe16;Contrast the two groups,Chi-square test results χ2=37.3, P<0.01;The difference of MPAD and MPAD/MAD between patient with pulmonaryhypertension and normal control group have Statistical significance(P<0.01).Spearmancorrelation analysis:there had positive correlation among age and MPAD and MAD,the correlation coefficients were r1=0.591, r2=0.699, while Spearman correlationcoefficient r=-0.016between age and MPAD/MAD, Spearman correlation coefficientof PASP and MPAD/MAD:r=0.678;The difference of MPAD/MAD werestatistically significant between the patients with and without pulmonaryhypertension(P<0.01);The difference of MPAD/MAD were statistically significantbetween the patients with chronic thromboembolic pulmonary hypertension andpulmonary hypertension secondary to chronic obstructive pulmonary disease (p<0.001);patiens with different classification of pulmonary hypertension,MPAD/MADare difference.Regard PASP≥35mmHg from echocardiography as the diagnostic criteriaof pulmonary hypertension,the specificity and sensitivity of MPAD/MAD≥0.97are92%and40%.Conclusion: Patients with pulmonary hypertension appeared widened of main pulmonary artery diameter and accretion of MPAD/MAD when taking lung computedtomographic examination; MPAD/MAD positively correlated with pulmonary arterysystolic pressure; MPAD/MAD difference was statistically significant among eithertypes of pulmonary hypertension;the MPAD/MAD measured by lung computedtomographic can be a basis for the diagnosis of pulmonary hypertension.