ArticleClinical research in cardiology : official journal of the German Cardiac Society2023
CT measured pulmonary artery to ascending aorta ratio stratified by echocardiographically obtained systolic pulmonary artery pressure values for noninvasive detection of pulmonary hypertension in patients with severe aortic valve stenosis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Right heart function matters: prognostic value of sPAP, TAPSE and RV-PA coupling in a real-world cohort of TAVI patients.Cardiovascular intervention and therapeutics · 2026Article
- Aortic regurgitation is associated with African American and Asian race, smoking, renal disease, and numerous autoimmune diseases in addition to traditional cardiovascular risk factors but has lower risk with alcohol intake.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Sex-specific utility of pulmonary artery metrics in predicting pulmonary hypertension and survival after TAVI: insights from advanced CT imaging.Insights into imaging · 2026Article
- Noninvasive assessment of pulmonary vascular resistance: a synergistic approach using computed tomography pulmonary angiography and echocardiography in pulmonary hypertension.Quantitative imaging in medicine and surgery · 2025Article
- The Prognostic Value of Tricuspid Annular Dimensions in TAVI Patients: A CT-Based Retrospective Analysis of Risk Stratification and Long-Term Outcomes.Journal of clinical medicine · 2025Article
- Radiological Parameters for the Detection of Pulmonary Hypertension in Severe Aortic Valve Stenosis and Their Influence on Mortality: Does Sex Matter?Journal of clinical medicine · 2024Article
- Elevated systolic pulmonary artery pressure is a substantial predictor of increased mortality after transcatheter aortic valve replacement in males, not in females.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
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Abstract
backgroundTransthoracic echocardiography (TTE) offers a measurement method for the determination of pulmonary hypertension (PH) in patients with severe aortic valve stenosis (AS) with determination of maximal tricuspid regurgitation velocity (TRVmax) and systolic pulmonary artery pressure (sPAP). Radiological parameters for noninvasive detection of PH, most importantly computed tomography (CT) based PA/AA-ratio = ratio of pulmonary artery diameter (PA) and ascending aorta diameter (AA), are also included in the latest ESC guidelines. The aim of the present study was to define cut-off values for PA/AA-ratio taking also into account cardiovascular biomarkers to determine criteria for noninvasive diagnosis of PH.
methods194 patients with severe AS undergoing transcatheter aortic valve replacement (TAVR) underwent pre-procedural TTE and CT with measurement of PA/AA-ratio. Additionally, common cardiovascular biomarkers were determined.
resultsTAVR patients with an sPAP ≥ 40 mmHg or a TRVmax ≥ 2.9 m/s had a PA/AA-ratio ≥ 0.80 in an AUROC analysis. The cut-off value of ≥ 0.80 resulted in a significantly higher mortality rate (log-rank test: p = 0.034) in these patients in a Kaplan-Meier analysis regarding 1-year survival after TAVR. Significant differences in biomarker expression between patients with a PA/AA-ratio ≥ 0.80 or < 0.80 occurred for BNP (p = 0.001), cTnI (p = 0.032), GDF-15 (p = 0.002) and H-FABP (p = 0.015).
conclusionPA/AA-ratio ≥ 0.80 is a promising radiological parameter that can provide information about mortality in patients with severe AS undergoing TAVR; combined with biomarkers it may contribute to noninvasive detection of PH in patients with severe AS.
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