Title: Pulmonary Vascular Changes in Pulmonary Hypertension
Abstract: HomeCirculation: Cardiovascular ImagingVol. 3, No. 3Pulmonary Vascular Changes in Pulmonary Hypertension Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessResearch ArticlePDF/EPUBPulmonary Vascular Changes in Pulmonary HypertensionOptical Coherence Tomography Findings Jingbo Hou, Hai Qi, Maomao Zhang, Lingbo Meng, Zhigang Han, Bo Yu and Ik-Kyung Jang Jingbo HouJingbo Hou From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. , Hai QiHai Qi From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. , Maomao ZhangMaomao Zhang From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. , Lingbo MengLingbo Meng From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. , Zhigang HanZhigang Han From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. , Bo YuBo Yu From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. and Ik-Kyung JangIk-Kyung Jang From the Department of Cardiology (J.H., H.Q., M.Z., L.M., Z.H., B.Y.), 2nd Affiliated Hospital of Harbin Medical University, and Key Laboratory of Education Ministry for Myocardial Ischemia Mechanism and Treatment, Harbin, China; and the Cardiology Division (I.-K.J.), Massachusetts General Hospital, Harvard Medical School, Boston, Mass. Originally published1 May 2010https://doi.org/10.1161/CIRCIMAGING.109.882498Circulation: Cardiovascular Imaging. 2010;3:344–345A 25-year-old man presented with a 3-month history of recurrent syncope, exertional chest discomfort, and shortness of breath. On physical examination, he had right ventricular heave, loud P2, jugular venous distension, tricuspid regurgitation murmur, and lower extremity edema. D-dimer was negative. Echocardiography showed right ventricular hypertrophy with elevated right ventricular pressure. Left ventricular function was normal. Cardiac catheterization showed pulmonary artery pressure of 131/50/78 mm Hg (concurrent aortic pressure was 145/80 mm Hg). Pulmonary wedge pressure was 15 mm Hg. Pulmonary angiography showed dilation of the main pulmonary artery with peripheral tapering (Figure 1). After pulmonary angiography, optical coherence tomography (LightLab Imaging Inc, Westford, Mass) and intravascular ultrasound (Boston Scientific) were per-formed. Optical coherence tomography images at the distal pulmonary artery are shown in Figure 2. The intima was more than twice in thickness in this patient with pulmonary hypertension (Figure 2A) compared with a patient with normal pulmonary pressure (Figure 2B). There was no evidence of mural thrombus. An intravascular ultrasound image of the corresponding site showed a strong echogenic layer that prohibited accurate measurement of intimal thickness (Figure 3). Download figureDownload PowerPointFigure 1. Pulmonary angiogram from a patient with pulmonary hypertension shows the markedly dilated pulmonary artery.Download figureDownload PowerPointFigure 2. At the level of the arteriole with the comparable luminal area (A, 1.71 mm2; B, 1.78 mm2) the intima is more than twice in the thickness in the patient with primary pulmonary hypertension (A) compared with another patient with normal pulmonary pressure (B) (0.26 versus 0.11 mm).Download figureDownload PowerPointFigure 3. Intravascular ultrasound of the pulmonary artery shows strong echo signal. An accurate measurement of intimal thickness is different.DisclosuresDr Jang received research grant and honorarium from LightLab Imaging.The study was approved by the hospital ethics committee and the written consent form was obtained before the start of the procedure.FootnotesCorrespondence to Bo Yu, MD, Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, PR China, 150086. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Sun L, Jiang Q, Xie Y, Wang S and Zhang Z (2022) Optical coherence tomography of the pulmonary arteries in children with congenital heart diseases: A systematic review, Pediatric Investigation, 10.1002/ped4.12353, 6:4, (264-270), Online publication date: 1-Dec-2022. Mody R (2022) Intracoronary Imaging-Can It Make Difference in State of the Art PCI?, Journal of Cardiology and Cardiovascular Research, 10.37191/Mapsci-JCCR-3(3)-066 Johns C, Wild J, Rajaram S, Swift A and Kiely D (2018) Current and emerging imaging techniques in the diagnosis and assessment of pulmonary hypertension, Expert Review of Respiratory Medicine, 10.1080/17476348.2018.1420478, 12:2, (145-160), Online publication date: 1-Feb-2018. Hong C, Luo F, Liu C, Zhong N, Li J and Wang W (2018) Clinical study of optical coherence tomography in the diagnosis of peripheral pulmonary artery thrombus, Thrombosis Research, 10.1016/j.thromres.2017.10.021, 161, (52-59), Online publication date: 1-Jan-2018. Schwaiger J, Loder C, Dobarro D, Kaier T, Reddecliffe S, Schreiber B, Handler C, Denton C and Coghlan J (2017) Optical coherence tomography evaluation of pulmonary arterial vasculopathy in Systemic Sclerosis, Scientific Reports, 10.1038/srep43304, 7:1 Jiang X, Peng F, Liu Q, Zhao Q, He J, Jiang R, Wang L, Xu X, LI J, Ebrahimi R and Jing Z (2016) Optical coherence tomography for hypertensive pulmonary vasculature, International Journal of Cardiology, 10.1016/j.ijcard.2016.07.215, 222, (494-498), Online publication date: 1-Nov-2016. Jorge E, Baptista R, Calisto J, Faria H, Monteiro P, Pan M and Pêgo M (2016) Optical coherence tomography of the pulmonary arteries: A systematic review, Journal of Cardiology, 10.1016/j.jjcc.2015.09.024, 67:1, (6-14), Online publication date: 1-Jan-2016. Yonetsu T, Villiger M, Bouma B and Jang I (2015) Cardiovascular Optical Coherence Tomography Optical Coherence Tomography, 10.1007/978-3-319-06419-2_72, (2131-2152), . Dai Z, Sugimura K, Fukumoto Y, Tatebe S, Miura Y, Nochioka K, Aoki T, Miyamichi-Yamamoto S, Yaoita N, Satoh K and Shimokawa H (2014) Visualization of Complete Regression of Pulmonary Arterial Remodeling on Optical Coherence Tomography in a Patient With Pulmonary Arterial Hypertension, Circulation Journal, 10.1253/circj.CJ-14-0224, 78:11, (2771-2773), . Domingo E, Grignola J, Aguilar R, Montero M, Arredondo C, Vázquez M, López-Messeguer M, Bravo C, Bouteldja N, Hidalgo C and Roman A In Vivo Assessment of Pulmonary Arterial Wall Fibrosis by Intravascular Optical Coherence Tomography in Pulmonary Arterial Hypertension: A New Prognostic Marker of Adverse Clinical Follow-Up§, The Open Respiratory Medicine Journal, 10.2174/1874306401307010026, 7:1, (26-32) Hong C, Wang W, Zhong N, Zeng G and Zhang N (2013) Visualization of Peripheral Pulmonary Artery Red Thrombi Utilizing Optical Coherence Tomography, Korean Journal of Radiology, 10.3348/kjr.2013.14.5.854, 14:5, (854), . Li N, Zhang S, Hou J, Jang I and Yu B (2012) Assessment of Pulmonary Artery Morphology by Optical Coherence Tomography, Heart, Lung and Circulation, 10.1016/j.hlc.2012.07.014, 21:12, (778-781), Online publication date: 1-Dec-2012. Lowe H, Narula J, Fujimoto J and Jang I (2011) Intracoronary Optical Diagnostics, JACC: Cardiovascular Interventions, 10.1016/j.jcin.2011.08.015, 4:12, (1257-1270), Online publication date: 1-Dec-2011. May 2010Vol 3, Issue 3 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCIMAGING.109.882498PMID: 20484114 Originally publishedMay 1, 2010 PDF download Advertisement SubjectsImagingPulmonary Hypertension