Pulmonary Venous Occlusion and Death in Pulmonary Arterial Hypertension: Survival Analyses Using Radiographic Surrogates

Overview

Journal BMC Pulm Med

Publisher Biomed Central

Specialty Pulmonary Medicine

Date 2011 Oct 7

PMID 21974838

Citations 1

Authors

Yasuko Takeda

Yutaka Takeda

Koji Yamamoto

Shigehiro Tomimoto

Tomomitsu Tani

Hitomi Narita

Nobuyuki Ohte

Genjiro Kimura

Affiliations

Soon will be listed here.

Abstract

Background: Recent studies find that a considerable number of patients with pulmonary arterial hypertension (PAH) develop fibrous obstruction of the pulmonary veins. Such obstruction more commonly accompanies connective tissue disorder (CTD)-associated PAH than idiopathic PAH. However, few researchers have gauged the risk of death involving obstruction of the pulmonary veins.

Methods: Thirty-seven patients with PAH were enrolled (18 patients, idiopathic PAH; 19 patients, CTD-associated PAH). The patients were 49 ± 18 years and had a World Health Organization functional class of 3.2 ± 0.6. Thickening of the interlobular septa, centrilobular ground-glass attenuation, and mediastinal adenopathy were surrogates for obstruction of the pulmonary veins, and were detected by a 16-row multidetector computed tomography scanner.

Results: The follow-up period was 714 ± 552 days. Fifteen deaths occurred. Thickening of the interlobular septa, centrilobular ground-glass attenuation, and mediastinal adenopathy were found in 37.8%, 24.3%, and 16.2% of patients, respectively. Cox proportional hazard analysis revealed an increased risk of death with each radiographic surrogate (mediastinal adenopathy: p < 0.0001, hazard ratio = 13.9; thickening of interlobular septa: p < 0.001, hazard ratio = 12.0; ground-glass attenuation: p = 0.02, hazard ratio = 3.7). The statistical significance of these relationships was independent of the cause of PAH and plasma concentration of brain natriuretic peptide.

Conclusions: The results of this study imply that obstruction of the pulmonary veins is associated with an increased risk of death in patients with PAH.

Citing Articles

Pulmonary veno-occlusive disease: the role of CT.

Mineo G, Attina D, Mughetti M, Balacchi C, De Luca F, Niro F Radiol Med. 2013; 119(9):667-73.

PMID: 24297597 DOI: 10.1007/s11547-013-0363-y.

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