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Pulmonary hypertension can be a result of left-sided heart disease (WHO group 2) or of intrinsic abnormalities of the pulmonary vasculature. In this study of 114 patients with pulmonary hypertension who underwent both right heart catheterization (RHC) and chest computed tomography (CT) with volumetric analysis of cardiac chambers, 27 (24%) were classified as WHO group 2 based on wedge pressure >15 mm Hg as determined by RHC.
Group 2 patients had significantly larger left heart volumes and smaller right ventricular volumes than did non–group 2 patients. In adjusted analyses, left atrial volume was an independent predictor of group 2 patients and left atrial enlargement identified those patients (area under the curve, 0.92).