Long term follow-up of radiological signs of pulmonary hypertension in correlation with haemodynamic changes.

Patients with pulmonary hypertension of unknown cause show a typical radiological pattern with prominence of the pulmonary segment, increase in diameter of the right descending branch of the pulmonary artery and marked tapering of the peripheral vascular bed. The aim of this study was to evaluate if changes in radiological indices correlate with hemodynamic changes during long term follow-up, in 19 patients with pulmonary hypertension followed for a mean of 8.4 years. In 10 patients, an increase in pulmonary arterial pressure (Ppa) was measured, and in all further increase in the diameter of the right descending branch was seen. The prominence of the pulmonary segment increased in only six of the ten patients. In three patients, no change in Ppa and in the radiological signs was noted. But in four of six patients a decrease in Ppa was not followed by changes of the radiological signs. In conclusion, we could show that there is a good correlation between radiological signs of pulmonary hypertension and further increase of pulmonary arterial pressure in patients with pulmonary hypertension, whereas a decrease in pressure is not necessarily reflected by a decrease in the radiological signs.