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Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography

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Abstract

Objectives

To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography.

Methods

104 patients (72.47 ± 13.64 years; 39 male) who had undergone chest CT and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived PASP of 25 mmHg. RV to LV volume ratios (RVV/LVV) were calculated. RVV/LVV was then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on chest CT was calculated.

Results

In the hypertensive group, the mean PASP was 46.29 ± 14.42 mmHg (29-98 mmHg) and there was strong correlation between the RVV/LVV and PASP (R = 0.82, p < 0.001). The intraobserver and interobserver correlation coefficients for RVV/LVV were 0.990 and 0.892. RVV/LVV was 1.01 ± 0.44 (0.51-2.77) in the hypertensive and 0.72 ± 0.14 (0.52-1.11) in the normotensive group (P <0.05). With 0.9 as the cutoff for RVV/LVV, sensitivity and specificity for predicting pulmonary hypertension over 40 mmHg were 79.5 % and 90 %, respectively. The AUC for predicting pulmonary hypertension was 0.87

Conclusion

RV/LV volume ratios on chest CT correlate well with PASP estimated by echocardiography and can be used to predict pulmonary hypertension over 40 mmHg with high sensitivity and specificity.

Key Points

• Chest CT is widely used in patients who may have pulmonary hypertension.

• Cardiac ventricular volume ratios on chest CT correlate with pulmonary arterial systolic pressure.

• A R/L ventricular volume ratio >0.9 usually indicates pulmonary hypertension >40 mmHg.

• Information available on routine chest CT may help predict pulmonary hypertension.

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Acknowledgements

UJ Schoepf receives research support from and is a consultant for Bayer, Bracco, GE, Medrad, and Siemens. SJ Lee is an employee of TeraRecon Korea. The other authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Radiology, Soon Chun Hyang University, Bucheon, Republic of Korea

    Heon Lee

  2. Department of Cardiology, Seoul Medical Center, Seoul, Republic of Korea

    Seok Yeon Kim

  3. Terarecon Korea, Seoul, Republic of Korea

    Soo Jeong Lee

  4. Department of Radiology, Chung-Ang University College of Medicine, Seoul, Republic of Korea

    Jae Kyun Kim

  5. Department of Radiology and Radiological Science and Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA

    Ryan P. Reddy & U. Joseph Schoepf

  6. Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Drive, Charleston, SC, 29401, USA

    U. Joseph Schoepf

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  1. Heon Lee
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  2. Seok Yeon Kim
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  3. Soo Jeong Lee
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Correspondence to U. Joseph Schoepf.

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Lee, H., Kim, S.Y., Lee, S.J. et al. Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography. Eur Radiol 22, 1929–1936 (2012). https://doi.org/10.1007/s00330-012-2454-x

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  • DOI: https://doi.org/10.1007/s00330-012-2454-x

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