Changes in main pulmonary artery diameter during follow-up have prognostic implications in pulmonary arterial hypertension

Respirology : Official Journal of the Asian Pacific Society of Respirology
Adriano R TonelliR A Dweik

Abstract

A dilated pulmonary artery (PA) is a common finding in patients with pulmonary arterial hypertension (PAH). Little is known on the variations in PA size over time and whether these changes track with disease severity and/or predict long-term survival. We included patients with PAH who had at least two computed tomography (CT) scans of the chest done on different visits. Both scans matched the use of i.v. contrast. Pairs of CT scans were compared in 113 PAH patients. During a median (interquartile range (IQR)) time difference between scans of 8 (IQR: 3.5-20.0) months, we noted an increase in main PA diameter of 0.5 ± 1.8 mm (mean ± SD) (P = 0.008). When CT scans were performed >12 months apart (n = 47), the main PA diameter increased or decreased by >1 mm in 40% and 13% of the patients, respectively. An increase in main PA diameter was associated with lower PA compliance, higher right ventricular (RV) systolic pressure, worse RV function and a decline in 6-min walk distance. During a median (IQR) follow-up of 33 (IQR: 4.5-47) months, 53 (46.9%) patients died. The change in PA diameter was a significant predictor of mortality (hazard ratio (HR) per mm increase: 1.33 (95% CI: 1.11-1.61), P = 0.002) when adjusted for difference in ...Continue Reading

References

Feb 2, 1999·American Journal of Respiratory and Critical Care Medicine·M D Botney
Jul 2, 2002·American Journal of Respiratory and Critical Care Medicine·UNKNOWN ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories
Oct 26, 2012·Journal of Thoracic Imaging·Abdelkader MahammediStanley S Siegelman
Apr 23, 2013·American Journal of Respiratory and Critical Care Medicine·Adriano R TonelliRaed A Dweik
Dec 21, 2013·Journal of the American College of Cardiology·Gerald SimonneauRogiero Souza
Dec 21, 2013·Journal of the American College of Cardiology·Marius M HoeperDavid B Badesch
Nov 20, 2014·Annals of the American Thoracic Society·Timothy E RaymondAdriano R Tonelli
Mar 3, 2015·Journal of Cardiac Surgery·Sossio Perrotta, Salvatore Lentini
Feb 24, 2016·Postgraduate Medicine·Wael Dakkak, Adriano R Tonelli
Apr 8, 2016·Cleveland Clinic Journal of Medicine·Mostafa AhmedAdriano R Tonelli

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Citations

Jul 6, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Martin I MacDonald
Feb 23, 2018·Respirology : Official Journal of the Asian Pacific Society of Respirology·Amanda J PiperVasileios Kouranos
Feb 27, 2021·Frontiers in Bioengineering and Biotechnology·Byron A ZambranoSeungik Baek

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