Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 30;13(3):453-464.
doi: 10.21037/cdt-22-421. Epub 2023 May 31.

Evaluation of the diagnostic and prognostic potential of optical coherence tomography (OCT) of the pulmonary arteries during standardised right heart catheterisation in patients with pulmonary hypertension: a cross-sectional single-centre experience

Emilie Zeiger  1 , André Jakob  1 , Robert Dalla Pozza  1 , Markus Fischer  1 , Anja Tengler  1 , Sarah M Ulrich  1 , Leonie Arnold  1 , Constance G Weismann  2 , Ingram Schulze-Neick  1 , Nikolaus A Haas  1 , Joseph Pattathu  1
Affiliations

Evaluation of the diagnostic and prognostic potential of optical coherence tomography (OCT) of the pulmonary arteries during standardised right heart catheterisation in patients with pulmonary hypertension: a cross-sectional single-centre experience

Emilie Zeiger et al. Cardiovasc Diagn Ther. .

Abstract

Background: Pulmonary hypertension (PH) is diagnosed based on an invasive evaluation of the mean pulmonary artery (PA) pressure. The morphological assessment of the pulmonary arteries was only recently not feasible. With the advent of optical coherence tomography (OCT)-imaging, an accessible tool allows to study PA morphology longitudinally. The primary hypothesis was that OCT distincts the PA structure of PH patients from control subjects. The secondary hypothesis was that PA wall thickness (WT) correlates with the progression of PH.

Methods: This is a retrospective monocentric study of 28 paediatric patients with (PH group) and without PH (control group) who had undergone cardiac catheterisation including OCT imaging of the PA branches. OCT parameters analysed were WT and the quotient of WT and diameter (WT/DM) and those were compared between the PH group and the control group. In addition, the OCT parameters were aligned with the haemodynamic parameters to evaluate the potential of OCT as a risk factor for patients with PH.

Results: WT and WT/DM in the PH group were significantly higher compared to the control group {WT: 0.150 [0.230, range (R): 0.100-0.330] vs. 0.100 [0.050, R: 0.080-0.130] mm, P<0.001; WT/DM: 0.06 [0.05] vs. 0.03 [0.01], P=0.006}. There were highly significant correlations between WT and WT/DM with the haemodynamic parameters mean pulmonary arterial pressure (mPAP) [Spearman correlation coefficient (rs) =0.702, P<0.001; rs=0.621, P<0.001], systolic pulmonary arterial pressure (sPAP) (rs=0.668, P<0.001; rs=0.658, P<0.001) and WT and pulmonary vascular resistance (PVR) (rs=0.590, P=0.02). Also, there was a significant correlation between WT and WT/DM and the risk factors quotient of mPAP and mean systemic arterial pressure (mSAP) (mPAP/mSAP) (rs=0.686, P<0.001; rs=0.644, P<0.001) and pulmonary vascular resistance index (PVRI) (rs=0.758, P=0.002; rs=0.594, P=0.02).

Conclusions: OCT can detect significant differences in WT of the PA in patients with PH. Furthermore, the OCT parameters correlate significantly with haemodynamic parameters and risk factors for patients with PH. More investigations are required to evaluate to what extent the impact of OCT can contribute to the clinical care of children with PH.

Keywords: Pulmonary hypertension (PH); optical coherence tomography (OCT); paediatric; wall thickness (WT).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-22-421/coif). ISN recently passed away and thus was unable to provide the form. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Selection of patients. OCT, optical coherence tomography.
Figure 2
Figure 2
Analysis of the OCT records. Analysis of the OCT records was a standardised procedure. Per patient, three cross-sections were analysed. In each analysed cross-section, DM was analysed semiautomatically once (left picture), and WT was analysed at three different locations in the pulmonary arterial wall (WT1, WT2, WT3) (right picture). DM, diameter; WT, wall thickness; OCT, optical coherence tomography.
Figure 3
Figure 3
OCT cross-sections of the pulmonary arterial wall in a patient of PH group and control group. Figure 3 shows two OCT cross-sections of the PA in a patient with PH (A) and in a patient without PH (B). WT assessed with OCT in the PA of the patient with PH is higher compared to the patient without PH. (A) WT: 0.20 mm, DM: 2.17 mm, WT/DM: 0.09, mPAP: 79 mmHg, sPAP: 95 mmHg. (B) WT: 0.09 mm, DM: 2.24 mm, WT/DM: 0.04, mPAP: 11 mmHg, sPAP: 19 mmHg. OCT, optical coherence tomography; PA, pulmonary artery; PH, pulmonary hypertension; WT, wall thickness; DM, diameter; WT/DM, quotient of WT and DM; mPAP, mean pulmonary arterial pressure; sPAP, systolic pulmonary arterial pressure.
Figure 4
Figure 4
Correlation of OCT parameters and haemodynamic parameters. Statistical test: Spearman correlation analysis. *, P value <0.05 is considered as statistically significant. In a group of 28 patients (PH: n=13, CG: n=15), the OCT parameters WT and WT/DM showed significant correlation with the haemodynamic parameters mPAP (rs=0.702, P<0.001; rs=0.621, P<0.001) and sPAP (rs=0.668, P<0.001; rs=0.658, P<0.001, also, correlation between WT and the haemodynamic parameter PVR was significant (rs=0.590, P=0.02). rs: Spearman correlation coefficient. WT, wall thickness; mPAP, mean pulmonary arterial pressure; PH, pulmonary hypertension; sPAP, systolic pulmonary arterial pressure; WT/DM, quotient of WT and DM; DM, diameter; PVR, pulmonary vascular resistance; WU, Wood units; OCT, optical coherence tomography; CG, control group.
Figure 5
Figure 5
Correlation of OCT parameters and risk factors. Statistical test: Spearman correlation analysis. *, P value <0.05 is considered as statistically significant. In a group of 28 patients (PH: n=13, CG: n=15), the OCT parameters WT and WT/DM showed significant correlation with the risk factors mPAP/mSAP (rs=0.686, P<0.001; rs=0.644, P<0.001) and PVRI (rs=0.758, P=0.002; rs=0.594, P=0.02). rs: Spearman correlation coefficient. WT, wall thickness; mPAP/mSAP, quotient of mPAP and mSAP; mPAP, mean pulmonary arterial pressure; mSAP, mean systemic arterial pressure; PH, pulmonary hypertension; PVRI, pulmonary vascular resistance index; WU, Wood units; WT/DM, quotient of WT and DM; DM, diameter; OCT, optical coherence tomography; CG, control group.
See this image and copyright information in PMC

References

    1. del Cerro Marín MJ, Sabaté Rotés A, Rodriguez Ogando A, et al. Assessing pulmonary hypertensive vascular disease in childhood. Data from the Spanish registry. Am J Respir Crit Care Med 2014;190:1421-9. 10.1164/rccm.201406-1052OC - DOI - PubMed
    1. van Loon RL, Roofthooft MT, Hillege HL, et al. Pediatric pulmonary hypertension in the Netherlands: epidemiology and characterization during the period 1991 to 2005. Circulation 2011;124:1755-64. 10.1161/CIRCULATIONAHA.110.969584 - DOI - PubMed
    1. Moledina S, Hislop AA, Foster H, et al. Childhood idiopathic pulmonary arterial hypertension: a national cohort study. Heart 2010;96:1401-6. 10.1136/hrt.2009.182378 - DOI - PubMed
    1. Mebus S, Apitz C, Diller GP, et al. Leitlinie Pädiatrische Kardiologie: Pulmonalarterielle Hypertonie (PAH) im Kindes- und Jugendalter. 2015. Available online: https://www.awmf.org/leitlinien/detail/ll/023-038.html
    1. Schulze-Neick I, Breuer J, Kreuder J, et al. Pulmonale Hypertonie (PH)1 (S2). In: Schmaltz AA. editor. Leitlinien zur Diagnostik und Therapie in der Pädiatrischen Kardiologie. München: Urban und Fischer in Elsevier, 2007:17-23.