Optical coherence tomography for hypertensive pulmonary vasculature

Abstract Background Optical coherence tomography (OCT) is an intravascular imaging modality capable of providing in situ images of tissues at near histologic resolution. In this study we examine the utility of OCT in identifying vascular changes related to pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results OCT of four different distal pulmonary arteries was performed during right heart catheterization in 87 patients, 64 patients with PAH and 23 patients with CTEPH. The mean luminal diameter measured by OCT for all patients was 2.26mm. Intimal thickening was significantly increased in all PAH patients (0.26±0.05mm in idiopathic PAH, 0.24±0.03mm in connective tissue disease related PAH, 0.26±0.06mm in congenital heart disease related PAH and 0.22±0.04mm in CTEPH, respectively) compared with controls (0.13±0.03mm) (all p p Conclusions OCT provides important information for assessment of pulmonary arterial remodeling in patients with PAH and improves diagnostic capability of angiographically undetected distal-thrombotic lesions in patients with CTEPH.