Evaluation of agreement coefficient between chest computed tomography and echocardiography in the diagnosis of pulmonary artery hypertension in patients with systemic sclerosis; a pilot study

Abstract

Introduction: Systemic sclerosis (SSc) is an autoimmune disorder that often presents with skin involvement. SSc affects various organs, and one of the most important of these organs is the cardiovascular system, which is one of the complications of this syndrome, including pulmonary arterial hypertension (PAH). Early diagnosis of this complication is very important due to the importance of the effect of PAH on mortality and morbidity of patients. For diagnosis of PAH, two methods of computed tomography (CT) scan and echocardiography are conducted. Objectives: In this study, we aimed to evaluate the agreement coefficient of chest CT scan in comparison with echocardiography in the diagnosis of PAH in patients with SSc. Patients and Methods: In a diagnostic study, which was conducted in Loghman hospital (Tehran-Iran), patients with a diagnosis of SSc were evaluated for pulmonary artery pressure (PAP) by echocardiography. For patients, a CT scan of the lungs was conducted and PAP was assessed. The results that obtained from the lungs CT scan were compared with the echocardiography results. Results: Fifty patients with SSc were evaluated. Eighty-four percent of patients were female and the mean age of all patients was 48.94 ± 11.02 years. About 16% of all patients had high PAP based on echocardiography and 28% of patients based on CT scan. Kappa’s agreement coefficient was 0.428 and Spearman’s correlation coefficient was 0.457. In other words, chest CT scan has a partly agreement with the echocardiography method (P value = 0.001). Conclusion: Chest CT scan has a high sensitivity, specificity, and accuracy compared to echocardiography as a screening method.