Abstract：
BACKGROUND: Identifying and understanding the microstructural changes within the wall of the pulmonary artery (PA) is crucial for elucidating disease mechanisms and guiding treatment strategies. We assessed the utility of optical coherence tomography (OCT) in identifying such changes within segmental/subsegmental PAs and compared the morphological variations in WHO group 4 pulmonary hypertension associated with Behcet Disease (BD), Takayasu arteritis (TA) and chronic thromboembolic pulmonary hypertension (CTEPH). Idiopathic pulmonary arterial hypertension (IPAH) patients served as controls.Methods and Results: A total of 197 cross-sectional images were analyzed from 20 consecutive patients. BD patients exhibited lower %wall area and mean wall thickness (MWT) compared with CTEPH, TA and, IPAH patients. TA patients showed a notably higher %wall area, which was significant in IPAH and BD patients. Variations in %wall area measurements were observed across distinct cross-sectional segments of the PA within individual patients (22% in CTEPH, 19% in BD, 16% in TA, 23% in IPAH patients). Intravascular webs, bands, and thrombi were observed in BD and CTEPH patients. OCT provided clear delineation of vascular wall calcifications and adventitial vasa vasorum. No procedure-related complications were observed.
CONCLUSIONS: PA involvement differs among the various etiologies of PH, with the PA being heterogeneously affected. OCT offers promise in elucidating microstructural vascular wall changes and providing insights into disease mechanisms and treatment effects.
CONCLUSIONS: PA involvement differs among the various etiologies of PH, with the PA being heterogeneously affected. OCT offers promise in elucidating microstructural vascular wall changes and providing insights into disease mechanisms and treatment effects.
摘要：
背景：识别和理解肺动脉（PA）壁内的微观结构变化对于阐明疾病机制和指导治疗策略至关重要。我们评估了光学相干断层扫描（OCT）在识别节段/亚节段PA内的这种变化中的实用性，并比较了与Behcet病（BD）相关的WHO第4组肺动脉高压的形态学变化。大动脉炎（TA）和慢性血栓栓塞性肺动脉高压（CTEPH）。特发性肺动脉高压（IPAH）患者作为对照。方法和结果：共分析了20例连续患者的197张横断面图像。BD患者表现出较低的%壁面积和平均壁厚（MWT）相比，CTEPH，TA和,IPAH患者。TA患者显示出较高的%壁面积，这在IPAH和BD患者中是显著的。在个别患者的PA的不同横截面段中观察到%壁面积测量值的变化(CTEPH中为22%,19%的BD，16%的TA，23%的IPAH患者)。血管内网,乐队,在BD和CTEPH患者中观察到血栓。OCT提供了血管壁钙化和血管外膜的清晰描绘。未观察到手术相关并发症。
结论：PA受累在PH的各种病因中有所不同，PA受到异质影响。OCT有望阐明血管壁的微观结构变化，并提供对疾病机制和治疗效果的见解。
结论：PA受累在PH的各种病因中有所不同，PA受到异质影响。OCT有望阐明血管壁的微观结构变化，并提供对疾病机制和治疗效果的见解。
