Abstract
Pulmonary hypertension (PH) is associated with decreased survival in patients with pulmonary fibrosis and combined pulmonary fibrosis and emphysema. Main pulmonary artery (PA) diameter and PA diameter/ascending aortic diameter (PA/AA) ratio, as measured on CT, have recently emerged as specific markers for PH. Our single-center retrospective study found that PA/AA ratio > 1 is associated with decreased survival in individuals with pulmonary fibrosis, with or without emphysema. Our study also describes markers of cardiac remodeling, and the echocardiographic diagnosis of PH in this patient population.
This is a preview of subscription content, log in via an institution to check access.
References
Wade RC, Simmons JP, Boueiz A, Gregory A, Wan ES, Regan EA, Bhatt SP, Han MK, Bowler RP, Crapo JD, Silverman EK, Washko GR, Dransfield MT, Wells JM (2021) Pulmonary artery enlargement is associated with exacerbations and mortality in ever-smokers with preserved ratio impaired spirometry (PRISm). Am J Respir Crit Care Med. https://doi.org/10.1164/rccm.202103-0619LE
Wells JM, Dransfield MT (2013) Pathophysiology and clinical implications of pulmonary arterial enlargement in COPD. Int J Chron Obstruct Pulmon Dis 8:509–521. https://doi.org/10.2147/COPD.S52204
Ng CS, Wells AU, Padley SP (1999) A CT sign of chronic pulmonary arterial hypertension: the ratio of main pulmonary artery to aortic diameter. J Thorac Imaging 14(4):270–278. https://doi.org/10.1097/00005382-199910000-00007
Truong QA, Massaro JM, Rogers IS, Mahabadi AA, Kriegel MF, Fox CS, O’Donnell CJ, Hoffmann U (2012) Reference values for normal pulmonary artery dimensions by noncontrast cardiac computed tomography: the Framingham heart study. Circ Cardiovasc Imaging 5(1):147–154. https://doi.org/10.1161/CIRCIMAGING.111.968610
Raymond TE, Khabbaza JE, Yadav R, Tonelli AR (2014) Significance of main pulmonary artery dilation on imaging studies. Ann Am Thorac Soc 11(10):1623–1632. https://doi.org/10.1513/AnnalsATS.201406-253PP
Terzikhan N, Bos D, Lahousse L, Wolff L, Verhamme KMC, Leening MJG, Felix JF, Gall H, Ghofrani HA, Franco OH, Ikram MA, Stricker BH, van der Lugt A, Brusselle G (2017) Pulmonary artery to aorta ratio and risk of all-cause mortality in the general population: the Rotterdam study. Eur Respir J 49(6):1602168. https://doi.org/10.1183/13993003.02168-2016
Jankowich MD, Rounds SIS (2012) Combined pulmonary fibrosis and emphysema syndrome: a review. Chest 141(1):222–231. https://doi.org/10.1378/chest.11-1062
Funding
No funding was received for conducting this study. This work was performed using resources and facilities of the Providence VA Medical Center. SR was supported by Grants from the NIH (1P20GM103652-01 and 5R01HL130230). Statistical support was provided through Advance Clinical and Translational Research (Advance-CTR) U54GM115677.
Author information
Authors and Affiliations
Contributions
FZ, MJ, SR conceptualized and designed this project, FZ and JM were responsible for data gathering, MKA performed radiological measurements, YW and DF performed statistical analysis. All authors contributed to drafting the manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
This study was performed after approval of the Providence VAMC Institutional Review Board.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Zeba, F., Yanning, W., Melek, J. et al. Prognostic Significance of Pulmonary Artery to Aorta Ratio and Other CT Markers in Pulmonary Fibrosis With and Without Emphysema. Lung 199, 677–680 (2021). https://doi.org/10.1007/s00408-021-00490-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00408-021-00490-2