| Objectives To measured the ratio of cross-sectional area on main pulmonary artery/ descending aorta by computed tomography (CT) investigate the relationship between the ratio and pulmonary artery hypertension, the lung and heart function in COPD patients complicated with pulmonary heart disease.Methods Eighty-two COPD patients complicated with pulmonary heart disease clinically proved as experimental group. At the same time,30 healthy examiners were compiled into the healthy control group. The cross-sectional area and diameter on main pulmonary artery and descending aorta were measured at the same level by chest CT for calculating the ratios of cross-sectional area and diameter in all the subjects. The PAPS, RVAW, EDRV and EFRV were detected by ultrasound cardiogram. The lung function were examined by respiratory function instrument. The serum BNP concentration was determinated by enzyme-linked immunosorbent assay. The relativity between the ratio of cross-sectional area and diameter on main pulmonary artery/descending aorta and pulmonary artery hypertension, the lung and heart function were analyzed.Results ①The ratios of cross-sectional area and diameter on main pulmonary artery/ descending aorta were increased significantly than control group(P<0.01,P<0.05).②The index of lung function (FEV1, FVC,FEV1/FVC% and FEV1 predicted) were decreased significantly than healthy control group (P<0.01,P<0.05). The value of PAPS and the level of serum BNP were increased significantly than control group (P<0.01, P< 0.05). The values of EFRV, EDRV and RVAW were decreased significantly than healthy control group (P<0.01).③ The ratio of diameter was negative correlated with FEV1/FVC%, FEV1 predicted, EFRV, EDRV and RVAW (r=-0.524,-0.671,-0.701,-0.536,-0.692, P<0.01), but the ratio of diameter was positively correlated with PAPS and BNP (r= 0.723,0.625, P< 0.01). The ratio of cross-sectional area was negative correlated with FEV1/FVC%,FEV1 predicted, EFRV, EDRV and RVAW (r=-0.632,-0.693,-0.733,-0.826,-0.776, P<0.01), but the ratio of cross-sectional area was positively correlated with PAPS and BNP(r=0.848,0.750, P<0.01).④ The area under ROC curve of cross-sectional area ratio to diagnose PAH was 0.823, but the area under ROC curve of diameter ratio to diagnose PAH was 0.715. The sensitivity of cross-sectional area ratio and diameter ratio respectively were 95.1% and 82.6%; the specificity respectively were 93.7% and 81.5%. The specificity of diameter ratio to diagnose heart function was 97.3% and the sensitivity was 41.2% when serum BNP was 400pg/ml, which in cross-sectional area ratio respectively were 92.4% and 84.8%. The sensitivity of cross-sectional area ratio and diameter ratio to diagnose lung function respectively were 96.4% and 83.7%, the specificity respectively were 95.5% and 94.8% when FEV1/FVC% was 80%.Conclusions ① The ratios of cross-sectional area and diameter as measured by CT are reliable and sensitive indicators to diagnose pulmonary heart disease complicated with pulmonary artery hypertension. The ratio of cross-sectional area has higher sensitivity and specificity than diameter ratio.②Ventilation dysfunction existed in COPD patients complicated with pulmonary heart disease. The ratios of cross-sectional area and diameter are associated with lung function. The sensitivity of cross-sectional area ratio to diagnose lung function is excelled the diameter ratio. There was no significant difference between cross-sectional area ratio and diameter ratio to diagnose lung function.③ Cardiac dysfunction existed in COPD patients complicated with pulmonary heart disease. The ratios of cross-sectional area and diameter are associated with heart function. The specificity is high but sensitivity is low in diameter ratio to diagnose heart function. The specificity and sensitivity are high in cross-sectional area ratio to diagnose heart function. |
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