The relationship between pulmonary artery pressure and pulmonary artery diameter in pulmonary hypertension

The pulmonary arteries dilate in response to many factors, principally increased pressure and flow. In patients who have pulmonary arterial hypertension but no increase in flow, we have compared main pulmonary artery size at computed tomography with pulmonary haemodynamic data obtained during right heart catheterisation. In patients with primary pulmonary hypertension and chronic thromboembolic pulmonary hypertension, dilatation correlated with raised pulmonary vascular resistance and reduced cardiac output but not with mean arterial pressure. In patients with chronic lung disease no correlations were shown though a trend between raised pressure and size was observed. We speculate that pulmonary artery compliance is an important factor which determines the degree of dilatation in response to raised pressure. Estimations of pressure cannot be made from measurements of pulmonary artery size without knowledge of the underlying lung disease.