Transesophageal Echocardiographic Assessment of Pulmonary Artery-to-Ascending Aorta Ratio for the Detection of Pulmonary Hypertension in Cardiac Surgical Patients

Kumar, Karthik Narendra; Singh, Naveen G; Nagaraja, P S; Patil, Thimmangouda Ayangouda; Manjunath, N

doi:10.1053/j.jvca.2017.05.012

Cited by 2 publications

(1 citation statement)

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“…One transesophageal echocardiographic study evaluated PA and ascending aorta diameters and PA:A. Here, mean PA diameter was 25mm, however mean diameter of the ascending aorta was 25mm, which lead to a PA:A of 1 differentiating between PH and non-PH [ 30 ]. More prospective data is needed comparing accuracy of echocardiographic measurements of the pulmonary artery.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary artery to ascending aorta ratio by echocardiography: A strong predictor for presence and severity of pulmonary hypertension

et al. 2020

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Background The pulmonary artery (PA) to ascending aorta diameter ratio (PA:A) has been evaluated in numerous studies analyzing cardiac magnetic resonance (CMR) and computed tomography (CT) data. Previously, no transthoracic echocardiography (TTE) cutoffs have been published. We sought to evaluate (1) the feasibility to image the pulmonary trunk in a prospective cohort, and (2) the ability of PA:A derived by TTE to predict pulmonary hypertension (PH). Methods We performed a post-hoc analysis of a prospectively recruited consecutive cohort of patients referred to our tertiary center cardiology department due to suspicion for PH. Invasive hemodynamic assessment and quasi-simultaneous TTE was performed in all participants. Results A total of 84 patients were included in the analysis, median age was 70.5 years (IQR 58–75), 46 (55%) were female. The PA was significantly wider in the PH group (28mm vs. 22.5mm, p<0.001) with a resulting median PA:A of 0.84 vs. 0.66 (p<0.001). Both PA diameter (r = 0.524 and r = 0.44, both p<0.001) and PA:A (r = 0.652 and 0.697, both p<0.001) significantly correlated with mPAP and with PVR, respectively. Area under the curve for the detection of PH was 0.853 (95%CI 0.739–0.967, p<0.001). Conclusion The PA can be visualized in almost all echocardiographic exams, especially when it is dilated. A view showing the pulmonary trunk should be included in every routine TTE. An increased PA:A should raise suspicion for PH and prompt further evaluation and follow-up examinations of these patients.

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Section: Discussionmentioning

confidence: 99%