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Morphology of the elastic pulmonary arteries in pulmonary hypertension: a quantitative study

Published online by Cambridge University Press:  19 August 2008

Karen A. McLeod ,
Leon M. Gerlis  and
Gordon J. Williams
Karen A. McLeod*
Affiliation:
Royal Hospital for Sick Children, Glasgow
Leon M. Gerlis
Affiliation:
Imperial College, London
Gordon J. Williams
Affiliation:
Yorkshire Heart Centre, Leeds, UK
*
Dr Karen A McLeod, Department of Cardiology, Royal Hospital for Sick Children, Glasgow G3 8SJ, UK. Tel: 0141 201 0000; Fax: 0141 201 0853
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Abstract

Recent studies of intravascular ultrasound of the pulmonary arteries suggest that the technique can detect intimal and medial thickening in patients with pulmonary hypertension, potentially providing a method of assessing severity of pulmonary vascular disease in life. A major drawback of the technique is that only the elastic pulmonary arteries are accessible to current ultrasound catheters. The aim of this study was to determine whether morphological changes in vessels accessible to intravascular imaging reflect severity of pulmonary vascular disease and are of a sufficient degree to be detectable by current ultrasound catheters. Morphometric studies of the elastic pulmonary arteries were performed in specimens of lungs from 24 patients who had died with pulmonary hypertension (aged 3 weeks–9 years) and compared with measurements from infants who had died from sudden infant death syndrome. Morphological changes evident in the elastic pulmonary arteries in pulmonary hypertension included luminal dilation and medial thickening but these changes were too variable to be predictive of the severity of peripheral pulmonary vascular disease. Intimal thickening and atherosclerosis were present only in those with advanced pulmonary hypertensive disease. The changes of medial thickening and luminal dilation, nonetheless, are too variable to be predictive of the severity of peripheral pulmonary vascular disease. Thus, imaging by intravascular ultrasound may help confirm advanced pulmonary vascular disease, but is unlikely to differentiate less severe pulmonary vascular disease when the patient may still potentially be operable.

Keywords

Elastic pulmonary arteriespulmonary hypertensionpulmonary vascular disease
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 4 , July 1999 , pp. 364 - 370
Copyright
Copyright © Cambridge University Press 1999

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