Analysis On The Predictive Value Of CAT Scale And Chest CT Vascular Measurement In The COPD-related Pulmonary Hypertension

Object To investigate the correlation of CAT Scale ? main pulmonary artery diameter(MPAD)?the ratio of main pulmonary artery/ascending aorta diameter(rPA)?the ratio of main pulmonary artery/descending aorta diameter(rPD)with COPD-ralated pulmonary hypertension,to analyze the prediction of them to COPD-ralated pulmonary hypertension.Methods 174 patients with COPD after active treatment?the state of lacking oxygen improved in respiratory department of The First Affiliated Hospital of Anhui Medical University were selected from December 2015 to June 2016.All of the patients in hospital were statisticed the age,gender,smoking status,height,weight and other information,all of the patients were checked of echocardiography and Chest CT in the day of before out of hospital,explained the CAT Scale and recorded the scores.Applying the Carestream Software to measure the diameter of the blood vessels in the Chest CT.MPAD?rPA?rPD were calculated based on the measured results.The patients were divided into the normal pulmonary tension?the mild group?the moderate to severe group according to the result of echocardiography.Compared the general information including age?gender?the rate of smoking?body mass index in thtee groups.Compared the difference of CAT Scale ? MPAD ? rPA ? rPD in three groups,analyzed their correlations to pulmonary artery pressure.Drawing ROC curve to understand the value of CAT Scale ? MPAD ? rPA ? rPD to the threshold of COPD-related pulmonary hypertension,to analyze the value of their predictions of COPD-related pulmonaryhypertension.Results 1.There were no difference in age ? gender ? body mass index in three groups,there were no significant statistically difference(P>0.05).There were difference in the rate of smoking,there were significant statistically difference(P<0.05).2.The CAT Scale?MPAD?rPA?rPD were higher in the mild group than in the normal group,there were significant statistically difference(P<0.05),there were no difference in rPA,there were no significant statistically difference(P > 0.05).The CAT Scale ?MPAD?rPA?rPD were higher in the moderate to severe group than in the normal group and mild group,there were significant statistically difference(P<0.05).3.Correlation analysis showed that CAT Scale ? MPAD ? rPA ? rPD were positiveiy associated with pulmonary hepertension,there were significant statistically difference(P<0.01).4.The prediction of CAT Scale?MPAD?rPA?rPD to the shreshold of COPD-related mild pulmonary hypertension were 21 points?33.5mm?0.95?1.12.the prediction of CAT Scale?MPAD?rPA?rPD to the shreshold of COPD-related moderate to severe pulmonary hypertension were 28 points?35.5mm?1.02?1.20.5.The combination of CAT Scale and MPAD?rPA?rPD to predict COPD-related mild pulmonary hypertension can give consideration to both sensitivity and specificity.The combination of CAT Scale and MPAD?rPA?rPD to predict COPD-related moderate to severe pulmonary hypertension can improve both sensitivity and specificity than single index.Conclusions CAT Scale and MPAD?rPA?rPD can be used to predict COPD-relatedpulmonary hypertension.The combination of CAT Scale and Chest CT vascular measurement to predict COPD-related pulmonary hypertension is better than single index.When CAT Scale>21 points?MPAD>33.5mm?rPA>0.95?rPD>1.12 suggest that COPD patients complicate with mild pulmonary hypertension.When CAT Scale>28 points ? MPAD > 35.5mm ? rPA > 1.02 ? rPD > 1.20 suggest that COPD patients complicate with moderate to severe pulmonary hypertension.