Purpose
Determinate through CT Pulmonary Angiogram(CTPA) the most common patterns and altered measurements obtained in patients with Human Immunodeficiency Virus infection(HIV), who developed as the main comorbidity Pulmonary Arterial Hypertension(PAH) previously confirmed by right heart catheterization (RHC). Correlate the radiological features along with laboratory-clinical factors.
The pathology includesviral and host factors,the proteinsassociated to HIVmay contribute tothe accumulation of inflammatory cells in the pulmonary arteries and increases the infection status withcoexisting conditions that are independently associated with pulmonary hypertension too.
CLINICAL RELEVANCE/APPLICATION
The impact of knowing the...
Methods and materials
A transversal and descriptive study were carried out. 10 patients underwent CTPA after fulfilled inclusion criteria: An adequate HIV follow-up, no other etiology established by Nice Classification 2013 and CRH confirmation. Vascular, cardiac and parenchymal-pulmonary variables analyzed by two observers separately. The images were blindly reviewed for an experienced observer (> 15 years of Cardiovascular Imaging)
Results
The median of the Cross-sectional values: Ascending-Aorta (AA):7,77mm2, Descending-Aorta (DA):4,42mm2; Pulmonary-Artery:13,5mm2. Mean value of Ratios DOAA/PA:1,2;DODA/PA:1,48. Mean size of Right and Left Pulmonary Arteries 26,3mm and 26mm respectively; Right Atrial 48,88mm, Right Ventricle 46,85mm, Left Ventricle 38,60mm, Ratio RV/ LV:1,21; RV wall-thickness 5,9mm. High arteriole/bronchiole ratio and mosaic-pattern represented 88%. Likewise, other findings as pericardial effusion(11%), chronic embolism (22%), PA calcification (11%), Reflux cava/hepatic veins(77%), Ground- glass pattern (11%), Collateralization (22%). Holders of inadequate Viral charges, CD4 and Pro-BNP amounts, presented higher values of Diameter...
Conclusion
The most prevalent features in patients HIV-PAH were: Higher values of Right Atrial size,Right Ventricular free wall thickness, Ratios DOAA/TAP, DODA/TAP, RV/LV, and ratio arteriole/bronchiole and the presence of Mosaic pattern. Also seen by Functional Group,CD4, Viral charges, and Pro-BNP values. Less common findings were Ground-Glass pattern, Bronchial collateralization, alterations LV size, or Cross-section of AA and DA. It has Created one of the first relying upon surveyed radiological-clinical HIV-PAH.
Personal information and conflict of interest
Sebastián Rivadeneira Rojas
Radiology Resident - Hospital Fernández. Buenos Aires - Argentina
Contact information:
[email protected]
Our research team has nothing to disclose.
References
Grosse, C., & Grosse, A. (2010). CT findings in diseases associated with pulmonary hypertension: A current review.Radiographics,30(7), 1753–1774.https://doi.org/10.1148/rg.307105710
L’Huillier, A. G., Posfay-Barbe, K. M., Pictet, H., & Beghetti, M. (2015). Pulmonary Arterial Hypertension among HIV-Infected Children: Results of a National Survey and Review of the Literature.Frontiers in Pediatrics,3.https://doi.org/10.3389/fped.2015.00025
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