Assessment of Pulmonary Artery Pulsatility by Multidetector Computed Tomography in Patients Affected by Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension: Preliminary Data

The aim was to assess if computed tomography is able to measure pulmonary artery pulsatility in patients affected by chronic obstructive pulmonary disease and to ascertain whether pulsatility is different in patients with and without pulmonary hypertension and whether it is related to haemodynamics. We selected two groups of patients, the first one with pulmonary hypertension and the second one without. In patient with hypertension, pulmonary artery pressure and resistance were increased with the increased diameters (transverse 36 ± 5 mm and axial 38 ± 4 mm versus 22 ± 3 and 25 ± 5, resp.), the increased cross-sectional area (10 ± 08 versus 4 ± 1 cm2), and the reduced pulsatility (21 ± 7 versus 10% ± 5%). Arterial stretching was decreased in patients with hypertension (10 ± 5 versus 21% ± 7%) and significantly related to pulmonary vascular resistances and pressure. Cardiac output measured by tomography was significantly related to that obtained by Fick method and was not different in the two groups. The diameters allow to identify patients with PH, assuming a cut-off of 28 mm and assuming a pulsatility of right branch of 26% as well. These preliminary observations indicate tomography as a suitable technique, being able to measure the pulsatility and the dimensions of the arteries and the right ventricular functional parameters.