Skip to main content
Top
Published in: European Spine Journal 10/2016

01-10-2016 | Original Article

Correlation between severity of adolescent idiopathic scoliosis and pulmonary artery systolic pressure: a study of 338 patients

Authors: Xing-ye Li, Zheng Li, Fan Feng, You-xi Lin, Hai-wei Guo, Li-gang Fang, Jin-qian Liang, Jian-guo Zhang, Gui-xing Qiu, Jian-xiong Shen

Published in: European Spine Journal | Issue 10/2016

Login to get access

Abstract

Purpose

Study of patients with adolescent idiopathic scoliosis.

Objective

To examine the correlation between pulmonary arterial pressure and coronal Cobb angle of idiopathic scoliosis.

Methods

A total of 338 patients (82.8 % female) with idiopathic scoliosis (average age 15.6 years; range 14–20 years) were included. Preoperatively, the coronal Cobb angle of curvature and the apex location and direction were determined from radiographic records. Tricuspid regurgitation velocity (TRV) and inferior vena cava diameter were also measured using Doppler echocardiography. Pulmonary arterial systolic pressure (sPAP) was calculated from the TRV according to the modified Bernoulli equation and correlations between sPAP and the features of scoliosis were identified by statistical analysis.

Results

Among the 338 patients, there were 305 thoracic curves, 276 (90.5 %) of which were right curves, and 265 thoracolumbar/lumbar curves. sPAP varied from 5.0 to 37.6 mmHg. Pulmonary hypertension could not be excluded in the case of one patient. A mild correlation (Spearman test, correlation coefficient = 0.187, P = 0.001) between sPAP and coronal Cobb angle of the main thoracic (MT) curves was identified. Correlations between sPAP and the degree of other curves were not significant. Patients with sPAP >20 mmHg also had larger thoracic curve angles (mean MT 42.16° vs. 52.45°; U test, P = 0.002). There were no differences in sPAP levels between patients with right and left thoracic curves.

Conclusions

A mild positive correlation was identified between sPAP and the coronal Cobb angle of the MT curves. There was no relationship between sPAP and the direction of the curvature.
Literature
1.
3.
go back to reference Dreimann M et al (2014) Scoliosis and chest cage deformity measures predicting impairments in pulmonary function: a cross-sectional study of 492 patients with scoliosis to improve the early identification of patients at risk. Spine (Phila Pa 1976) 39(24):2024–2033CrossRef Dreimann M et al (2014) Scoliosis and chest cage deformity measures predicting impairments in pulmonary function: a cross-sectional study of 492 patients with scoliosis to improve the early identification of patients at risk. Spine (Phila Pa 1976) 39(24):2024–2033CrossRef
4.
go back to reference Weinstein SL, Zavala DC, Ponseti IV (1981) Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am 63(5):702–712PubMed Weinstein SL, Zavala DC, Ponseti IV (1981) Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am 63(5):702–712PubMed
5.
go back to reference Newton PO et al (2005) Results of preoperative pulmonary function testing of adolescents with idiopathic scoliosis. A study of six hundred and thirty-one patients. J Bone Joint Surg Am 87(9):1937–1946CrossRefPubMed Newton PO et al (2005) Results of preoperative pulmonary function testing of adolescents with idiopathic scoliosis. A study of six hundred and thirty-one patients. J Bone Joint Surg Am 87(9):1937–1946CrossRefPubMed
6.
go back to reference Pehrsson K et al (1992) Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 17(9):1091–1096CrossRef Pehrsson K et al (1992) Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa 1976) 17(9):1091–1096CrossRef
7.
go back to reference Branthwaite MA (1986) Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest 80(4):360–369CrossRefPubMed Branthwaite MA (1986) Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest 80(4):360–369CrossRefPubMed
8.
go back to reference Bergofsky EH, Turino GM, Fishman AP (1959) Cardiorespiratory failure in kyphoscoliosis. Medicine (Baltimore) 38:263–317CrossRef Bergofsky EH, Turino GM, Fishman AP (1959) Cardiorespiratory failure in kyphoscoliosis. Medicine (Baltimore) 38:263–317CrossRef
9.
go back to reference Shneerson JM, Venco A, Prime FJ (1977) A study of pulmonary artery pressure, electrocardiography, and mechanocardiography in thoracic scoliosis. Thorax 32(6):700–705CrossRefPubMedPubMedCentral Shneerson JM, Venco A, Prime FJ (1977) A study of pulmonary artery pressure, electrocardiography, and mechanocardiography in thoracic scoliosis. Thorax 32(6):700–705CrossRefPubMedPubMedCentral
10.
go back to reference Sarwahi V et al (2014) Adolescent idiopathic scoliosis patients are at increased risk for pulmonary hypertension which reverses after scoliosis surgery. Spine J 14(11 Supplement):S153–S154 Sarwahi V et al (2014) Adolescent idiopathic scoliosis patients are at increased risk for pulmonary hypertension which reverses after scoliosis surgery. Spine J 14(11 Supplement):S153–S154
11.
go back to reference Berger M et al (1985) Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 6(2):359–365CrossRefPubMed Berger M et al (1985) Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound. J Am Coll Cardiol 6(2):359–365CrossRefPubMed
12.
go back to reference Yock PG, Popp RL (1984) Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 70(4):657–662CrossRefPubMed Yock PG, Popp RL (1984) Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 70(4):657–662CrossRefPubMed
13.
go back to reference Galie N et al (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 30(20):2493–2537CrossRefPubMed Galie N et al (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 30(20):2493–2537CrossRefPubMed
14.
go back to reference Hoeper MM et al (2013) Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol 62(25 Suppl):D42–D50CrossRefPubMed Hoeper MM et al (2013) Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol 62(25 Suppl):D42–D50CrossRefPubMed
15.
go back to reference Currie PJ et al (1985) Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. J Am Coll Cardiol 6(4):750–756CrossRefPubMed Currie PJ et al (1985) Continuous wave Doppler determination of right ventricular pressure: a simultaneous Doppler-catheterization study in 127 patients. J Am Coll Cardiol 6(4):750–756CrossRefPubMed
16.
go back to reference Danielsson AJ (2013) Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50 degrees. J Child Orthop 7(1):37–41CrossRefPubMed Danielsson AJ (2013) Natural history of adolescent idiopathic scoliosis: a tool for guidance in decision of surgery of curves above 50 degrees. J Child Orthop 7(1):37–41CrossRefPubMed
17.
go back to reference Weinstein SL et al (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289(5):559–567CrossRefPubMed Weinstein SL et al (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA 289(5):559–567CrossRefPubMed
18.
20.
go back to reference Hanley T et al (1958) Heart failure of the hunchback. Q J Med 27(106):155–171PubMed Hanley T et al (1958) Heart failure of the hunchback. Q J Med 27(106):155–171PubMed
21.
22.
go back to reference Jackson RP, Simmons EH, Stripinis D (1989) Coronal and sagittal plane spinal deformities correlating with back pain and pulmonary function in adult idiopathic scoliosis. Spine (Phila Pa 1976) 14(12):1391–1397CrossRef Jackson RP, Simmons EH, Stripinis D (1989) Coronal and sagittal plane spinal deformities correlating with back pain and pulmonary function in adult idiopathic scoliosis. Spine (Phila Pa 1976) 14(12):1391–1397CrossRef
23.
go back to reference Upadhyay SS et al (1995) Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 20(22):2415–2420CrossRef Upadhyay SS et al (1995) Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 20(22):2415–2420CrossRef
24.
go back to reference Aaro S, Ohlund C (1984) Scoliosis and pulmonary function. Spine (Phila Pa 1976) 9(2):220–222CrossRef Aaro S, Ohlund C (1984) Scoliosis and pulmonary function. Spine (Phila Pa 1976) 9(2):220–222CrossRef
25.
26.
go back to reference Yu W, Song K, Zhang Y, Zheng GQ, Dong T (2014) Relationship between lung volume and pulmonary function in patients with adolescent idiopathic scoliosis: computed tomographic-based three-dimensional volumetric reconstruction of lung parenchyma. J Spinal Disord Tech. doi:10.1097/bsd.0000000000000161 Yu W, Song K, Zhang Y, Zheng GQ, Dong T (2014) Relationship between lung volume and pulmonary function in patients with adolescent idiopathic scoliosis: computed tomographic-based three-dimensional volumetric reconstruction of lung parenchyma. J Spinal Disord Tech. doi:10.​1097/​bsd.​0000000000000161​
27.
28.
go back to reference Liu JM et al (2012) Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction. Chin Med J (Engl) 125(2):249–252 Liu JM et al (2012) Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction. Chin Med J (Engl) 125(2):249–252
29.
go back to reference Leong JC et al (1999) Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 24(13):1310–1315CrossRef Leong JC et al (1999) Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 24(13):1310–1315CrossRef
30.
go back to reference Giordano A et al (1997) Evaluation of pulmonary ventilation and diaphragmatic movement in idiopathic scoliosis using radioaerosol ventilation scintigraphy. Nucl Med Commun 18(2):105–111CrossRefPubMed Giordano A et al (1997) Evaluation of pulmonary ventilation and diaphragmatic movement in idiopathic scoliosis using radioaerosol ventilation scintigraphy. Nucl Med Commun 18(2):105–111CrossRefPubMed
31.
go back to reference Ito K et al (2012) Scoliosis associated with airflow obstruction due to endothoracic vertebral hump. Spine (Phila Pa 1976) 37(25):2094–2098CrossRef Ito K et al (2012) Scoliosis associated with airflow obstruction due to endothoracic vertebral hump. Spine (Phila Pa 1976) 37(25):2094–2098CrossRef
32.
33.
go back to reference Secker-Walker RH, Ho JE, Gill IS (1979) Observations on regional ventilation and perfusion in kyphoscoliosis. Respiration 38(4):194–203CrossRefPubMed Secker-Walker RH, Ho JE, Gill IS (1979) Observations on regional ventilation and perfusion in kyphoscoliosis. Respiration 38(4):194–203CrossRefPubMed
34.
go back to reference Moudgil R, Michelakis ED, Archer SL (1985) Hypoxic pulmonary vasoconstriction. J Appl Physiol 98(1):390–403CrossRef Moudgil R, Michelakis ED, Archer SL (1985) Hypoxic pulmonary vasoconstriction. J Appl Physiol 98(1):390–403CrossRef
35.
go back to reference Voelkel NF (1986) Mechanisms of hypoxic pulmonary vasoconstriction. Am Rev Respir Dis 133(6):1186–1195PubMed Voelkel NF (1986) Mechanisms of hypoxic pulmonary vasoconstriction. Am Rev Respir Dis 133(6):1186–1195PubMed
37.
go back to reference Finkelhor RS, Lewis SA, Pillai D (2015) Limitations and strengths of doppler/echo pulmonary artery systolic pressure-right heart catheterization correlations: a systematic literature review. Echocardiography 32(1):10–18CrossRefPubMed Finkelhor RS, Lewis SA, Pillai D (2015) Limitations and strengths of doppler/echo pulmonary artery systolic pressure-right heart catheterization correlations: a systematic literature review. Echocardiography 32(1):10–18CrossRefPubMed
Metadata
Title
Correlation between severity of adolescent idiopathic scoliosis and pulmonary artery systolic pressure: a study of 338 patients
Authors
Xing-ye Li
Zheng Li
Fan Feng
You-xi Lin
Hai-wei Guo
Li-gang Fang
Jin-qian Liang
Jian-guo Zhang
Gui-xing Qiu
Jian-xiong Shen
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 10/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4471-y

Other articles of this Issue 10/2016

European Spine Journal 10/2016 Go to the issue