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Clinical and prognostic relationships of pulmonary artery to aorta diameter ratio in patients with heart failure: a cardiac magnetic resonance imaging study

Etheridge, Marilyn; Pellicori, Pierpaolo; Urbinati, Alessia; Zhang, Jufen; Joseph, Anil C.; Costanzo, Pierluigi; Lukaschuk, Elena; Capucci, Alessandro; Cleland, John G.F.; Clark, Andrew L.

Authors

Marilyn Etheridge

Pierpaolo Pellicori

Alessia Urbinati

Jufen Zhang

Anil C. Joseph

Pierluigi Costanzo

Elena Lukaschuk

Alessandro Capucci

John G.F. Cleland

Andrew L. Clark



Abstract

Background
The pulmonary artery (PA) distends as pressure increases.

Hypothesis
The ratio of PA to aortic (Ao) diameter may be an indicator of pulmonary hypertension and consequently carry prognostic information in patients with chronic heart failure (HF).

Methods
Patients with chronic HF and control subjects undergoing cardiac magnetic resonance imaging were evaluated. The main PA diameter and the transverse axial Ao diameter at the level of bifurcation of the main PA were measured. The maximum diameter of both vessels was measured throughout the cardiac cycle and the PA/Ao ratio was calculated.

Results
A total of 384 patients (mean age, 69 years; mean left ventricular ejection fraction, 40%; median NT‐proBNP, 1010 ng/L [interquartile range, 448–2262 ng/L]) and 38 controls were included. Controls and patients with chronic HF had similar maximum Ao and PA diameters and PA/Ao ratio. During a median follow‐up of 1759 days (interquartile range, 998–2269 days), 181 patients with HF were hospitalized for HF or died. Neither PA diameter nor PA/Ao ratio predicted outcome in univariable analysis. In a multivariable model, only age and NT‐proBNP were independent predictors of adverse events.

Conclusions
The PA/Ao ratio is not a useful method to stratify prognosis in patients with HF.

Citation

Pellicori, P., Urbinati, A., Zhang, J., Joseph, A. C., Costanzo, P., Lukaschuk, E., …Clark, A. L. (2018). Clinical and prognostic relationships of pulmonary artery to aorta diameter ratio in patients with heart failure: a cardiac magnetic resonance imaging study. Clinical cardiology, 41(1), 20-27. https://doi.org/10.1002/clc.22840

Journal Article Type Article
Acceptance Date Oct 19, 2017
Online Publication Date Jan 23, 2018
Publication Date Feb 8, 2018
Deposit Date Jul 3, 2018
Publicly Available Date Jan 24, 2019
Print ISSN 0160-9289
Electronic ISSN 1932-8737
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 41
Issue 1
Pages 20-27
DOI https://doi.org/10.1002/clc.22840
Keywords Pulmonary artery; Aortic diameter; PA/Ao ratio; Heart failure; Cardiac MRI; Prognosis
Public URL https://hull-repository.worktribe.com/output/908755
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1002/clc.22840
Copyright Statement ©2018 University of Hull
Additional Information This is the accepted manuscript of an article published in Clinical cardiology, 2018. The version of record is available at the DOI link in this record.

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