Pulmonary artery to aorta ratio for the detection of pulmonary hypertension: cardiovascular magnetic resonance and invasive hemodynamics in heart failure with preserved ejection fraction

Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance
Gültekin KarakusJulia Mascherbauer

Abstract

Previous work indicates that dilatation of the pulmonary artery (PA) itself or in relation to the ascending aorta (PA:Ao ratio) predicts pulmonary hypertension (PH). Whether these results also apply for heart failure with preserved ejection fraction (HFpEF) is unknown. In the present study we evaluated the diagnostic and prognostic power of PA diameter and PA:Ao ratio on top of right ventricular (RV) size, function, and septomarginal trabeculation (SMT) thickness by cardiovascular magnetic resonance (CMR) in HFpEF. 159 consecutive HFpEF patients were prospectively enrolled. Of these, 111 underwent CMR and invasive hemodynamic evaluation. By invasive assessment 64 % of patients suffered from moderate/severe PH (mean pulmonary artery pressure (mPAP) ≥30 mmHg). Significant differences between groups with and without moderate/severe PH were observed with respect to PA diameter (30.9 ± 5.1 mm versus 26 ± 5.1 mm, p < 0.001), PA:Ao ratio (0.93 ± 0.16 versus 0.78 ± 0.14, p < 0.001), and SMT diameter (4.6 ± 1.5 mm versus 3.8 ± 1.2 mm; p = 0.008). The strongest correlation with mPAP was found for PA:Ao ratio (r = 0.421, p < 0.001). By ROC analysis the best cut-off for the detection of moderate/severe PH was found for a PA:Ao ratio of 0.8...Continue Reading

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Citations

Aug 3, 2016·The Cochrane Database of Systematic Reviews·Andrew J WardleJ Simon R Gibbs
Dec 30, 2017·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Warren J Manning
Aug 26, 2017·Circulation. Cardiovascular Imaging·Sherif F NaguehJerry D Estep
Jun 18, 2017·The European Respiratory Journal·Aline N Zouk, J Michael Wells
Jan 24, 2016·Wiener klinische Wochenschrift·Andreas A Kammerlander
Apr 5, 2018·Scientific Reports·Marlies AntlangerJulia Mascherbauer
Nov 17, 2016·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·D J PennellD N Firmin
Jul 6, 2020·European Respiratory Review : an Official Journal of the European Respiratory Society·Sudeep R AryalSteven G Lloyd
Nov 14, 2020·Current Cardiovascular Imaging Reports·Samer AlabedAndrew J Swift

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