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A study of correlation between transhilar diameter and p pulmonale in copd patients.

BACKGROUND: Early diagnosis and therapy of Pulmonary hypertension in COPD patients may help in retardation of progression and amelioration of symptoms. This is an attempt to diagnose the disease from X-ray chest of COPD patients, so that invasive investigations can be avoided.

OBJECTIVES: (1) Measurement of transhilar diameter in Chest X-ray PA view of COPD patients and its importance in detection of pulmonary hyper-tension. (2) To study correlation between P pulmonale and transhilar diameter / hilar thoracic ratio.

DESIGN: Prospective Clinical study.

SETTING: Institute of Chest Diseases, Medical College, Calicut.

PERIOD OF STUDY: One year from September 2002 to August 2003.

MATERIALS AND METHODS: 100 patients admitted to Institute of Chest Diseases with COPD and ECG evidence of P pulmonale and/or RVH were included. Chest X-rays was taken and the following diameters were measured. Transhilar diameter, hilar thoracic ratio, width of descending branch of (Rt) pulmonary artery and cardiothoracic ratio.

CONCLUSIONS: Chest X-ray can be used for identification of pulmonary hypertension in COPD patients. Positive correlation was seen between P pulmonale and hilar thoracic ratio. Positive correlation was also seen between P pulmonale and other parameters like smoking status, symptom duration, ECG evidence of RVH and negative correlation was seen with % predicted FEV(1).

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