Conference: 2012 International PHA Conference and Scientific Sessions
Release Date: 06.22.2012
Presentation Type: Abstracts
Demir Baykal, MD, FACC, FASE, Diplomate SCCT
Gwinnett Consultants in Cardiology , Medical Software LLC Duluth GA
BACKGROUND: There are many resemblances between pathology of PAH and atherosclerosis such as intimal thickening, media hypertrophy, neorevascularization.However the incidence and correlates of calcium deposition in pulmonary arterial tree in PAH is unknown. In addition no ideal screening method exists for early diagnosis of PAH in high risk populations. We hypothesize that detection of calcium deposition may be useful in screening for PAH and total calcium score of pulmonary arterial tree may parallel the disease severity determined by 6 minutes walk test or hemodynamics.
METHODS: Multislice noncontrast CT exams were obtained in 8 Patients (mean age =52) with known WHO group1 PAH (mean PAP =38 mmHg, 1 familial, 3 idiopathic and 5 associated, NYHA class 2-3 at the time of diagnosis) using speedlight VCT. Pulmonary arterial tree calcium scoring was done using Agaston volumetric method.Findings were plotted against functional class , hemodynamics and compared to those of age, gender matched control group referred for coronary calcium scoring.
RESULTS: All 8 patients with PAH had positive PA calcium score, whereas only 3 had positive coronary calcium score, not unexpectedly all with connective tissue disease. None of the control group had calcium detection in pulmonary arterial tree. The pulmonary artery total calcium score only roughly correlates with mean PA pressure.
CONCLUSION: Main and branch pulmonary artery calcification is universal in class 2 to 3 PAH patients, whereas coronary calcification is uncommon in this population. Contrarily pulmonary artery calcification is uncommon in the absence of clinical diagnosis of PAH. Total pulmonary calcium score may reflect disease severity