Figures
- FIGURE 1
Measures obtained from the computed tomography scan that are useful for the radiological suspicion of pulmonary hypertension (PH). Main pulmonary artery (MPA) dilatation values >29 mm in men and >27 mm in women are strongly related to PH (sensitivity 87%, specificity 89%), when its value is >35 mm the specificity reaches 100%. Right and left pulmonary artery (RPA and LPA, respectively) diameter>18 mm is abnormal. MPA dilatation and an ascending aorta (AAO) diameter ratio >1, in individuals <50 years old and with diffuse pulmonary fibrosis, is highly specific for hypertension (specificity >90%, sensitivity 70%). In patients with severe COPD this ratio is more accurate than echocardiography.
Tables
- TABLE 1
Updated clinical classification of pulmonary hypertension (PH)
1 PAH 1.1 Idiopathic PAH
1.2 Heritable PAH
1.3 Drug- and toxin-induced PAH
1.4 PAH associated with:
1.4.1 Connective tissue disease
1.4.2 HIV infection
1.4.3 Portal hypertension
1.4.4 Congenital heart disease
1.4.5 Schistosomiasis
1.5 PAH long-term responders to calcium channel blockers
1.6 PAH with overt features of venous/capillaries (PVOD/PCH) involvement
1.7 Persistent PH of the newborn syndrome
2 PH due to left heart disease 2.1 PH due to heart failure with preserved LVEF
2.2 PH due to heart failure with reduced LVEF
2.3 Valvular heart disease
2.4 Congenital/acquired cardiovascular conditions leading to post-capillary PH
3 PH due to lung diseases and/or hypoxia 3.1 Obstructive lung disease
3.2 Restrictive lung disease
3.3 Other lung disease with mixed restrictive/obstructive pattern
3.4 Hypoxia without lung disease
3.5 Developmental lung disorders
4 PH due to pulmonary artery obstructions 4.1 Chronic thromboembolic PH
4.2 Other pulmonary artery obstructions
5 PH with unclear and/or multifactorial mechanisms 5.1 Haematological disorders
5.2 Systemic and metabolic disorders
5.3 Others
5.4 Complex congenital heart disease
PAH: pulmonary arterial hypertension; PVOD: pulmonary veno-occlusive disease; PCH: pulmonary capillary haemangiomatosis; LVEF: left ventricular ejection fraction. Reproduced from [8] with permission from the publisher.
- TABLE 2
Principle variables in 6-min walk related to a poor prognosis in patients affected by idiopathic pulmonary fibrosis
Value predictors of a poor prognosis Distance m <250 SpO2 nadir % <88 HRR bpm <13 DSP %·m <200 SpO2: arterial oxygen saturation measured by pulse oximetry; HRR: heart rate recovery after 1 min following the test; DSP: distance saturation product, the product of the 6-min walk distance and the lowest registered SpO2.
- TABLE 3
Principle variables in 6-min walk test related to a poor prognosis in patients affected by COPD
Value predictors of a poor prognosis Distance m ≤334 6MWspeed m·s−1 ≤0.8 6MWW m·kg−1 ≤20 000 DSP %·m ≤290 6MWspeed: calculated by dividing the 6-min walk distance by the total walking time; 6MWW: 6-min walking work, the product of the 6-min walking distance and the patient weight; DSP: distance saturation product, the product of the 6-min walk distance and the lowest registered arterial oxygen saturation measured by pulse oximetry.
