Non-invasive estimation of pulmonary arterial hypertension in chronic obstructive pulmonary disease

The feasibility and reliability of the combination of several noninvasive m ethods using a multivariate method of analysis to predict pulmonary artery hypertension (PAH) is evaluated in 20 patients with chronic obstructive pul monary disease. These methods comprised arterial blood gases (PaO2, PaCO2), pulmonary functional parameters (FEV1), echo-Doppler parameters (tricuspid regurgitation jets, acceleration time on pulmonary valve), computed tomogr aphy measurements (transhilar distance, hilar thoracic index, and measureme nt of the descending branch of the right pulmonary artery to the lower lobe ). A multiple stepwise regression analysis (including one Doppler parameter , two parameters of arterial blood gases, and one functional parameter) rev ealed a coefficient of determination (R-2) equal to 0.954 for mean pulmonar y artery pressure (MPAP) with a standard error of estimate (S.E.E.) of 5.25 mmHg. A stepwise regression analysis including computed tomography and rad iographic parameters revealed an R-2 equal to 0.970 for PAP with a S.E.E. o f 4.26 mmHg. Logistical regression analysis classified correctly 80% of pat ients with PAH using noninvasive methods such as the diameter of the main p ulmonary artery and the diameter of the left pulmonary arterial branch calc ulated by computed tomography. Not only the presence of PAH but also the le vel of MPAP can be estimated by the combination of multiple stepwise and lo gistical regression analyses.