CHEST Guidelines-Quantification-of-Arterial-and-Venous-Morphologic-

Quantification-of-Arterial-and-Venous-Morphologic-

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The study, "Quantification of Arterial and Venous Morphologic Markers in Pulmonary Arterial Hypertension Using CT Imaging," explores the manifestations of vascular pruning and tortuosity in pulmonary arterial hypertension (PAH) and exercise pulmonary hypertension (ePH). Conducted by a team of researchers from Brigham and Women’s Hospital, the study leverages advanced artificial intelligence to analyze CT scans from 91 subjects categorized into PAH, ePH, and control cohorts.<br /><br />The investigation reveals that patients with PAH demonstrate lower distal pulmonary small vessel volumes, increased proximal arterial dilation, and higher arterial tortuosity compared to control subjects. The study also extends these findings to patients with ePH, who show similar vascular patterns, albeit without the significant proximal dilation noted in PAH. Pruning, the reduction in smaller blood vessels, and the shift towards larger blood vessel volumes were observed to be significant in both arterial and venous trees for PAH, suggesting systemic alterations in vascular morphology. <br /><br />The study's key contribution lies in the ability of noninvasive CT imaging methods to detect these morphological changes, providing early detection potential for PAH and possibly identifying ePH as a precursor stage. The use of automated techniques promises a scalable solution for screening and monitoring PAH, offering a less invasive alternative to right heart catheterization.<br /><br />Furthermore, the study emphasizes the importance of understanding the differential impacts of these changes on arteries and veins, improving the interpretation of CT imaging in diagnosing and managing PAH. These findings could influence the development of diagnostic markers and enhance our understanding of pulmonary vascular remodeling in these conditions.

Keywords

pulmonary arterial hypertension

vascular pruning

CT imaging

arterial tortuosity

vascular morphology

artificial intelligence

noninvasive detection

diagnostic markers

pulmonary vascular remodeling

exercise pulmonary hypertension