Document Detail


Progressive dilatation of the main pulmonary artery is a characteristic of pulmonary arterial hypertension and is not related to changes in pressure.
MedLine Citation:
PMID:  20495109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary artery (PA) dilatation is one of the consequences of pulmonary arterial hypertension (PAH) and is used for noninvasive detection. However, it is unclear how the size of the PA behaves over time and whether it is related to pressure changes. The aim of this study was to evaluate PA size during follow-up in treated patients with PAH and whether it reflects pulmonary vascular hemodynamics.
METHODS: Fifty-one patients with PAH who underwent at least two right-sided heart catheterizations (RHCs) together with cardiac MRI (CMR) were included in this study. Another 18 patients who had normal pressure at RHC were included for comparison at baseline. From RHC, we derived PA pressures and cardiac output. From the CMR images we derived PA diameter (PAD) and the ratio of the PAD and ascending aorta diameter.
RESULTS: The PAD was significantly larger in patients with PAH than in patients without PAH (P < .001). A ratio of the PAD and ascending aorta diameter > 1 had a positive predictive value of 92% for PAH. Mean follow-up time was 942 days, and there was a significant dilatation during this period (P < .001). The change of the PAD did not correlate with the changes in pressure or cardiac output. A moderate correlation with follow-up time was found (r = 0.56; P < .001).
CONCLUSIONS: A dilatated PA is useful for identifying patients with PAH. However, during patient follow-up, progressive dilatation of the PA is independent of the change in PA pressure and cardiac output and might become independent from hemodynamics.
Authors:
Bart Boerrigter; Gert-Jan Mauritz; J Tim Marcus; Frank Helderman; Pieter E Postmus; Nico Westerhof; Anton Vonk-Noordegraaf
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-21
Journal Detail:
Title:  Chest     Volume:  138     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-08     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1395-401     Citation Subset:  AIM; IM    
Affiliation:
VU University Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Blood Pressure Determination
Cardiac Output
Cohort Studies
Dilatation, Pathologic / pathology,  radiography
Disease Progression
Female
Follow-Up Studies
Heart Catheterization / methods
Hemodynamics / physiology*
Humans
Hypertension, Pulmonary / diagnosis*,  drug therapy
Magnetic Resonance Angiography
Male
Monitoring, Physiologic / methods
Prospective Studies
Pulmonary Artery / pathology,  radiography*
Reproducibility of Results
Severity of Illness Index
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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