Pulmonary Artery Dimensions as a Prognosticator of Transplant-Free Survival in Scleroderma Interstitial Lung Disease

Gleason, James Benjamin; Patel, K.; Hernandez, Felix; Hadeh, Anas; Highland, Kristin B.; Rahaghi, Franck; Mehta, J.P.

doi:10.1007/s00408-017-0005-6

Cited by 12 publications

(5 citation statements)

References 31 publications

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“…Analyses adjusting for the presence or absence of radiographic honeycombing demonstrated that the presence of MLN enlargement predicts TFS (HR, 1.45; 95% CI, 1.06-1.99; P = 0.022) and respiratory hospitalization (internal rate of return [IRR], 1.62; 95% CI, 1.09-2.41; P = 0.017) independent of radiographic honeycombing. Additional sensitivity analyses adjusting for PA diameter measurements as a surrogate for pulmonary hypertension (28)(29)(30) demonstrated that presence of MLN enlargement predicts TFS and respiratory hospitalization independent of PA diameter (HR, 1.53; 95% CI, 1.11-2.10, P = 0.009 and IRR, 1.57, 95% CI, 1.05-2.34, P = 0.028, respectively) or PA/aorta ratio (HR, 1.51; 95% CI, 1.10-2.08; P = 0.012 and IRR, 1.69; 95% CI, 1.14-2.51; P = 0.009, respectively).…”

Section: Primary Outcome Assessmentmentioning

confidence: 99%

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Adegunsoye

Oldham

Bonham

et al. 2019

Am J Respir Crit Care Med

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Section: Primary Outcome Assessmentmentioning

confidence: 99%

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Adegunsoye

Oldham

Bonham

et al. 2019

Am J Respir Crit Care Med

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“…The ratio was able to detect patients with PH [2][3][4][5][6], it correlated with hemodynamics [7][8][9][10], and it was predictive for morbidity [11][12][13] and mortality [14][15][16][17]. Different cutoffs for PA:A have been suggested to identify PH, depending on the methodology (CMR or CT), ranging from 0.83 to >1 [2,14,[18][19][20][21]. Previously, no TTE cutoffs have been published.…”

Section: Introductionmentioning

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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“…Moreover, 2 studies found increased rates of transplantation and death in patients with interstitial lung disease and higher PA:AA. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Larger pulmonary artery to ascending aorta ratios are associated with decreased survival of patients undergoing pulmonary endarterectomy

et al. 2022

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Pulmonary Artery Dimensions as a Prognosticator of Transplant-Free Survival in Scleroderma Interstitial Lung Disease

Abstract: In SSc-ILD patients, a PA:Ao ratio ≥1.1 is associated with higher risk of lung transplant or death. These data suggest that PA:Ao dimension may be used for prognostication in SSc-ILD.

Cited by 12 publications

References 31 publications

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation

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

Larger pulmonary artery to ascending aorta ratios are associated with decreased survival of patients undergoing pulmonary endarterectomy

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