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Assessment of ventilation-perfusion scans in patients with chronic thromboembolic pulmonary hypertension before and after surgery and correlation with clinical parameters.

Authors
  • Nachand, Douglas1
  • Huang, Steve1
  • Bullen, Jennifer2
  • Heresi, Gustavo A3
  • Renapurkar, Rahul D4
  • 1 Imaging Institute, Cleveland Clinic, United States of America. , (United States)
  • 2 Quantitative Health Sciences, Cleveland Clinic, United States of America. , (United States)
  • 3 Department of Pulmonary and Critical Care Medicine, Cleveland Clinic, United States of America. , (United States)
  • 4 Imaging Institute, Cleveland Clinic, United States of America. Electronic address: [email protected] , (United States)
Type
Published Article
Journal
Clinical imaging
Publication Date
Oct 01, 2020
Volume
66
Pages
147–152
Identifiers
DOI: 10.1016/j.clinimag.2020.04.041
PMID: 32531708
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We did a comparative analysis of matched and mismatched defects in pre- and post-operative V/Q scans in CTEPH patients. We correlated the number of these defects with pre-operative clinical and hemodynamic parameters. This was a retrospective study on 27 patients with CTEPH who underwent surgery. Pre- and post-operative V/Q scans were graded for each lung segment as normal, matched or mismatched defect. Additional pre- and post-operative clinical and hemodynamic parameters that were collected include New York Heart Association functional class, six-minute walk distance in feet, N-terminal pro b-type natriuretic peptide, forced expiratory volume in one second/forced vital capacity, diffusing capacity of the lung for carbon monoxide, pulmonary arterial pressure (systolic, diastolic and mean), right atrial pressure, cardiac output and cardiac index. Pulmonary vascular resistance was then calculated. On a segmental basis, 176 mismatched defects were noted in 27 patients, of which 111 improved post-surgery (63%). 22 of the 34 matched defects improved following surgery (64%). 31 new mismatched defects were observed. The number of pre-operative matched defects per patient ranged from 0 to 6. No statistically significant associations were observed between the number of pre-operative matched defects and pre-operative clinical parameters. No statistically significant associations were observed between the number of improved matched defects and the change in clinical parameters (pre- to post-surgery). Both matched and mismatched defects on preoperative V/Q scans can show normalization post-surgery. The extent of matched defects on a preoperative V/Q scan does not correlate significantly with other clinical and hemodynamic parameters. Copyright © 2020 Elsevier Inc. All rights reserved.

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