Pulmonary artery size as a predictor of outcomes in idiopathic pulmonary fibrosis. Issue 5 (4th February 2016)

• Record Type: Journal Article
• Authors: Shin, Stephanie; King, Christopher S.; Puri, Nitin; Shlobin, Oksana A.; Brown, A. Whitney; Ahmad, Shahzad; Weir, Nargues A.; Nathan, Steven D.
• Is Part Of: European respiratory journal. Volume 47:Issue 5(2016)
• Page Start: 1445
• Page End: 1451
• Publication Date: 2016-02-04
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01532-2015
• Languages: English
• ISSNs: 0903-1936

Abstract

IPF patients have heightened propensity for pulmonary hypertension, which portends a worse outcome. Presence of pulmonary hypertension may be reflected in an enlarged pulmonary artery. We investigated pulmonary artery size measured on high-resolution computed tomography (HRCT) as an outcome predictor in IPF. We retrospectively reviewed all IPF patients evaluated at a tertiary-care centre between 2008 and 2013. Pulmonary artery and ascending aorta diameters were measured from chest HRCT with pulmonary artery:ascending aorta diameter (PA:A) ratio calculations. Outcome analysis defined by either death or lung transplant based on pulmonary artery size and PA:A ratio over 60 months was performed. Independent effects of different variables on overall outcomes were evaluated using the Cox proportional hazards model. 98 IPF patients with available HRCT scans had a mean pulmonary artery diameter and PA:A ratio of 32.8 mm and 0.94, respectively. Patients with a PA:A ratio >1 had higher risk of death or transplant compared with a PA:A ratio ≤1 (p<0.001). A PA:A ratio >1 was also an independent predictor of outcomes in unadjusted and adjusted outcomes analyses (hazard ratio 3.99, p<0.001 and hazard ratio 3.35, p=0.002, respectively). A PA:A ratio >1 is associated with worse outcomes in patients with IPF. HRCT PA:A ratio measurement may assist in risk stratification and prognostication of IPF patients. Pulmonary artery measurements on imaging can be utilised for risk stratification and prognostication in IPF http://ow.ly/WNO2h