Pulmonary hypertension in patients with bronchiectasis: prognostic significance of CT signs.

Abstract

The purpose of this study was to evaluate the association between pulmonary hypertension estimated with CT and outcome among patients with bronchiectasis. The cases of 91 patients with bronchiectasis were studied. CT signs of pulmonary hypertension examined were main pulmonary artery diameter, right and left main pulmonary artery diameters, and the ratio between the diameters of the main pulmonary artery and the ascending aorta. CT scans were scored for extent of bronchiectasis and presence of bronchial dilatation, bronchial wall thickening, mucous plugging, mosaicism, and emphysema. Univariate, bivariate, and multivariate Cox proportional hazards models were used to test the influence of CT signs on mortality. Average right and left main pulmonary artery diameter was the best predictor of mortality (hazard ratio, 1.24; 95% CI, 1.13-1.35; p < 0.0001) and was associated with outcome independent of CT signs of bronchiectasis. Pulmonary hypertension, reflected by pulmonary arterial enlargement on CT scans, is a highly significant prognostic indicator in the evaluation of patients with bronchiectasis.