Multidimensional CT approach to predict hemodynamics in PH

Introduction: mPAP measured by RHC is the current cornerstone on PH diagnosis. Non-invasive techniques as angioCT allow for an excellent visualization of heart chambers and great vessels, and its measures may be associated with hemodynamic parameters, obviating the need for some invasive procedures. Purpose: To evaluate the association between angioCT measurements with hemodynamics, clinical and labdata in this population. Methods: Consecutive pts with precapillary PH followed were evaluated with angioCT and RHC performed within a time interval of 6 months. Clinical, laboratorial, imagiological and hemodynamic data were collected from all pts. ROC curve analysis was applied to estimate the best angioCT parameters cut-offs for severe PH. Results: Our cohort included 47 pts, 12 with clinical group I and 37 with group 4. Pts had a mean mPAP of 44mmHg and a mean NT-proBNP of 1109ng/mL, 56% were in functional class (FC) II and 21% in FC III. A significant correlation was observed between mean mPAP and angioCT parameters - septal angle (r 0.595, p <0.001), right ventricle axial area (r 0.463,p=0.001), RA axial area (r 0.374, p 0.010), RV free wall thickness and RV axial diameter. For a mPAP over 35mmHg the optimal cut-off for the previously correlated parameters were the following: septal angle value of 149º, RV axial area of 22.71, RA axial area of 20.9mm2, and RV free wall thickness of 6.45mm. AngioCT parameters correlated with hemodynamics but also with clinical and laboratory parameters, as a higher RV and RA axial area had a significant positive correlation with NT-proBNP and worse FC Conclusions: In this trial, non-invasive parameters by CT-Angio correlated with hemodynamic parameters by RHC, class and NTproBNP.