Xi Qunying, Liu Zhihong, Xiong Changming, Luo Qin, Zhao Zhihui, Zhao Qing, Yang Tao, Zeng Qixian, Li Pingwei, Qiu Luwen
Pulmonary Vascular Diseases Ward, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen China.
Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Pulm Circ. 2023 Dec 6;13(4):e12313. doi: 10.1002/pul2.12313. eCollection 2023 Oct.
Pulmonary artery (PA) dilatation is commonly observed in patients with pulmonary hypertension (PH). However, the clinical aspects of PA dilatation in various etiology of PH remain unknown. In this study, we investigated the clinical and imaging characteristics of 1018 patients with different subtypes of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The independent determinants for all-cause death were identified using univariate and multivariate Cox proportional hazard models. PA dilatation was identified in 88.8% of the patients, and 27.2% had a PA diameter/ascending aorta diameter ratio greater than 1.5. PA diameter was shown to be significantly correlated with hemodynamic parameters and symptom duration in idiopathic PAH patients. PA diameter only correlated with pulmonary circulation volume in patients with PAH associated with congenital heart disease. PA diameter correlated with symptom duration and right ventricular end-diastolic dimension in CTEPH patients. PA diameter correlated with right ventricular end-diastolic dimension in patients with PAH associated with connective tissue disease. Only 6-min walk distance, but not PA dilatation, predicts all-cause death independently. In conclusion, PA dilatation is a common finding in PH patients. The clinical feature of PA dilatation varies greatly between PH types. PA dilatation is not associated with all-cause death.
肺动脉（PA）扩张在肺动脉高压（PH）患者中较为常见。然而，不同病因的PH患者中PA扩张的临床特征仍不清楚。在本研究中，我们调查了1018例不同亚型肺动脉高压（PAH）和慢性血栓栓塞性肺动脉高压（CTEPH）患者的临床和影像学特征。使用单因素和多因素Cox比例风险模型确定全因死亡的独立决定因素。88.8%的患者存在PA扩张，27.2%的患者PA直径/升主动脉直径比大于1.5。在特发性PAH患者中，PA直径与血流动力学参数和症状持续时间显著相关。在先天性心脏病相关PAH患者中，PA直径仅与肺循环容量相关。在CTEPH患者中，PA直径与症状持续时间和右心室舒张末期内径相关。在结缔组织病相关PAH患者中，PA直径与右心室舒张末期内径相关。仅6分钟步行距离而非PA扩张可独立预测全因死亡。总之，PA扩张在PH患者中很常见。PA扩张的临床特征在不同类型的PH之间差异很大。PA扩张与全因死亡无关。
