Evidence map›Paper›PMID 31351047›Full record

ArticleChest2020

Right Ventricular to Left Ventricular Ratio at CT Pulmonary Angiogram Predicts Mortality in Interstitial Lung Disease.

Simon Bax, Joseph Jacob, Riaz Ahmed, Charlene Bredy, Konstantinos Dimopoulos, Aleksander Kempny, Maria Kokosi, Gregory Kier, Elisabetta Renzoni, Philip L Molyneaux and 9 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 57 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 6 institutions in 4 countries.

Simon BaxNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England; Surrey and Sussex Hospital, Redhill, Surrey, England; National Heart and Lung Institute, Imperial College, London, England. Electronic address: s.bax@nhs.net.
Joseph JacobDepartment of Respiratory Medicine, University College London, London, England; Centre for Medical Image Computing, University College London, London, England.
Riaz AhmedSurrey and Sussex Hospital, Redhill, Surrey, England.
Charlene BredyNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England; CHU Arnaud de Villeneuve, Montpellier, France.
Konstantinos DimopoulosNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England; National Heart and Lung Institute, Imperial College, London, England.
Aleksander KempnyNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England.
Maria KokosiDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England.
Gregory KierPrincess Alexandra Hospital, Department of Respiratory Medicine, Woolloongabba, Australia.
Elisabetta RenzoniDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England.
Philip L MolyneauxDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England; Fibrosis Research Group, National Heart and Lung Institute, Imperial College, London, England.
Felix ChuaDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England.
Vasilis KouranosDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England.
Peter GeorgeDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England; National Heart and Lung Institute, Imperial College, London, England.
Colm McCabeNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England.
Michael WildeSurrey and Sussex Hospital, Redhill, Surrey, England.
Anand DevarajDepartment of Radiology, Royal Brompton and Harefield NHS Trust, London, England.
Athol WellsDepartment of Interstitial Lung Diseases, Royal Brompton and Harefield NHS Trust, London, England.
S John WortNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England; National Heart and Lung Institute, Imperial College, London, England.
Laura C PriceNational Pulmonary Hypertension Service, Royal Brompton and Harefield NHS Trust, London, England.
Royal Brompton & Harefield NHS Foundation Trust · GBEast Surrey Hospital · GBImperial College London · GBLung Institute · USPrincess Alexandra Hospital · AUUniversity College London · GB

Funding

Department of Health PB-PG-0712-28073Versus Arthritis 20719Wellcome Trust 209553
6 · The paper itself

Abstract

backgroundPatients with interstitial lung disease (ILD) may develop pulmonary hypertension (PH), often disproportionate to the severity of the ILD. The right ventricular to left ventricular diameter (RV:LV) ratio measured at CT pulmonary angiogram (CTPA) has been shown to provide valuable information in patients with pulmonary arterial hypertension and to predict death or deterioration in acute pulmonary embolism.

methodsDemographic characteristics, ILD subtype, echocardiography, and detailed CTPA measurements were collected in consecutive patients undergoing both CTPA and right heart catheterization at the Royal Brompton Hospital between 2005 and 2015. Fibrosis severity was formally scored according to CT criteria. The RV:LV ratio at CTPA was evaluated by using three different methods. Cox proportional hazards analysis was used to assess the relation of CTPA-derived parameters to predict death or lung transplantation.

resultsA total of 92 patients were included (64% male; mean age 65 ± 11 years) with an FVC 57 ± 20% predicted, corrected transfer factor of the lung for carbon monoxide 22 ± 8% predicted, and corrected transfer coefficient of the lung for carbon monoxide 51 ± 17% predicted. PH was confirmed at right heart catheterization in 78%. Of all the CTPA-derived measures, an RV:LV ratio ≥ 1.0 strongly predicted mortality or transplantation at univariate analysis (hazard ratio, 3.26; 95% CI, 1.49-7.13; P = .003), whereas invasive hemodynamic data did not. The RV:LV ratio remained an independent predictor at multivariate analysis (hazard ratio, 3.19; 95% CI, 1.44-7.10; P = .004), adjusting for an ILD diagnosis of idiopathic pulmonary fibrosis and CT imaging-derived ILD severity.

conclusionsAn increased RV:LV ratio measured at CTPA provides a simple, noninvasive method of risk stratification in patients with suspected ILD-PH. This should prompt closer follow-up, more aggressive treatment, and consideration of lung transplantation.

Indexed as

Computed Tomography AngiographyAgedEchocardiographyFemaleHumansHypertension, PulmonaryLung Diseases, InterstitialMaleMiddle AgedPulmonary ArteryRespiratory Function TestsSeverity of Illness IndexCT scan pulmonaryinterstitial lung diseasepulmonary hypertensionright ventricle

Identifiers

PMID31351047
PMCPMC7615159
OpenAlexW2962693765

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.