CT-determined pulmonary artery to aorta ratio as a predictor of elevated pulmonary artery pressure and survival in idiopathic pulmonary fibrosis

被引：51

作者：

Yagi, Mitsuaki ^{[1
,2
]}

Taniguchi, Hiroyuki ^{[1
]}

Kondoh, Yasuhiro ^{[1
]}

Ando, Masahiko ^{[3
]}

Kimura, Tomoki ^{[1
]}

Kataoka, Kensuke ^{[1
]}

Furukawa, Taiki ^{[1
,2
]}

Suzuki, Atsushi ^{[1
,2
]}

Johkoh, Takeshi ^{[4
]}

Hasegawa, Yoshinori ^{[2
]}

机构：

[1] Tosei Gen Hosp, Dept Resp Med & Allergy, 160 Nishioiwake Cho, Seto, Aichi 4898642, Japan

[2] Nagoya Univ, Grad Sch Med, Dept Resp Med, Nagoya, Aichi, Japan

[3] Nagoya Univ Hosp, Ctr Adv Med & Clin Res, Nagoya, Aichi, Japan

[4] Mutual Aid Assoc Publ Hlth Teachers, Kinki Cent Hosp, Dept Radiol, Itami, Hyogo, Japan

来源：

RESPIROLOGY | 2017年 / 22卷 / 07期

关键词：

interstitial lung disease; pulmonary circulation and pulmonary hypertension; pulmonary fibrosis; radiology and other imaging; PROGNOSTIC INDICATOR; SYSTEMIC-SCLEROSIS; HYPERTENSION; LUNG; OUTCOMES; DISEASE; COPD; ECHOCARDIOGRAPHY; GUIDELINES; MORTALITY;

D O I：

10.1111/resp.13066

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background and objective: Elevated mean pulmonary artery pressure (mPAP) is a significant prognostic indicator in idiopathic pulmonary fibrosis (IPF). It has been reported that the computed tomography-determined ratio of the diameter of the pulmonary artery to the aorta (PA: A) is correlated with mPAP in various respiratory diseases. However, in patients with IPF, whether the PA: A can be used to predict elevated mPAP and the prognostic value of the PA: A has not been fully evaluated. Methods: We conducted a single-centre, observational study of 177 consecutive IPF patients who underwent right heart catheterization. We examined the association between the PA: A and mPAP in these patients, and performed a receiver operating characteristic (ROC) analysis to test the diagnostic accuracy of the PA: A in predicting mPAP > 20 mm Hg (pulmonary hypertension (PH) or borderline PH) in relation to survival. Results: In a multivariate linear regression analysis, the PA: A, 6-min walk distance and diffusion capacity for carbon monoxide (DLCO) % predicted were independent explanatory variables of elevated mPAP (P < 0.0001, P = 0.009 and P = 0.002, respectively). ROC analysis revealed a PA: A > 0.9 to be optimal for predicting mPAP > 20 mmHg (area under the curve (AUC) = 0.75; 95% CI: 0.65-0.84). Patients with a PA: A > 0.9 also had a worse prognosis (P = 0.009). Conclusion: Measurement of the PA: A is a useful and convenient method to predict elevated mPAP in IPF at initial evaluation. Moreover, a PA: A > 0.9 was found to be an indicator of worse prognosis.

引用

页码：1393 / 1399

页数：7

共 34 条

[1] Non-invasive screening for pulmonary hypertension in idiopathic pulmonary fibrosis [J].

Alkukhun, Laith ;

Wang, Xiao-Feng ;

Ahmed, Mostafa K. ;

Baumgartner, Manfred ;

Budev, Marie M. ;

Dweik, Raed A. ;

Tonelli, Adriano R. .

RESPIRATORY MEDICINE, 2016, 117 :65-72

[2] STANDARDIZATION OF SPIROMETRY - 1994 UPDATE [J].

不详 .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1995, 152 (03) :1107-1136

[3]

[Anonymous], 2004, Nihon Kokyuki Gakkai Zasshi, VSuppl, P1

[4]

Corte TJ, 2009, SARCOIDOSIS VASC DIF, V26, P7

[5] ATS statement: Guidelines for the six-minute walk test [J].

Crapo, RO ;

Casaburi, R ;

Coates, AL ;

Enright, PL ;

MacIntyre, NR ;

McKay, RT ;

Johnson, D ;

Wanger, JS ;

Zeballos, RJ ;

Bittner, V ;

Mottram, C .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 166 (01) :111-117

[6] Categorization and impact of pulmonary hypertension in patients with advanced COPD [J].

Cuttica, Michael J. ;

Kalhan, Ravi ;

Shlobin, Oksana A. ;

Ahmad, Shahzad ;

Gladwin, Mark ;

Machado, Roberto F. ;

Barnett, Scott D. ;

Nathan, Steven D. .

RESPIRATORY MEDICINE, 2010, 104 (12) :1877-1882

[7] The Effect of Diffuse Pulmonary Fibrosis on the Reliability of CT Signs of Pulmonary Hypertension [J].

Devaraj, Anand ;

Wells, Athol U. ;

Meister, Mark G. ;

Corte, Tamera J. ;

Hansell, David M. .

RADIOLOGY, 2008, 249 (03) :1042-1049

[8] 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension [J].

Galie, Nazzareno ;

Humbert, Marc ;

Vachiery, Jean-Luc ;

Gibbs, Simon ;

Lang, Irene ;

Torbicki, Adam ;

Simonneau, Gerald ;

Peacock, Andrew ;

Noordegraaf, Anton Vonk ;

Beghetti, Maurice ;

Ghofrani, Ardeschir ;

Sanchez, Miguel Angel Gomez ;

Hansmann, Georg ;

Klepetko, Walter ;

Lancellotti, Patrizio ;

Matucci, Marco ;

McDonagh, Theresa ;

Pierard, Luc A. ;

Trindade, Pedro T. ;

Zompatori, Maurizio ;

Hoeper, Marius .

EUROPEAN RESPIRATORY JOURNAL, 2015, 46 (04) :903-975

[9] Significance of pulmonary arterial pressure and diffusion capacity of the lung as prognosticator in patients with idiopathic pulmonary fibrosis [J].

Hamada, Kunio ;

Nagai, Sonoko ;

Tanaka, Shigeru ;

Handa, Tomohiro ;

Shigematsau, Michio ;

Nagao, Taishi ;

Mishima, Michiaki ;

Kitaichi, Masanori ;

Izumi, Takateru .

CHEST, 2007, 131 (03) :650-656

[10] CT Scan-Measured Pulmonary Artery to Aorta Ratio and Echocardiography for Detecting Pulmonary Hypertension in Severe COPD [J].

Iyer, Anand S. ;

Wells, J. Michael ;

Vishin, Sonia ;

Bhatt, Surya P. ;

Wille, Keith M. ;

Dransfield, Mark T. .

CHEST, 2014, 145 (04) :824-832

← 1 2 3 4 →