Department of Cardiology, Ardahan State Hospital, 75000, Ardahan, Turkey.
Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training Hospital, Istanbul, Turkey.
Herz. 2024 Dec;49(6):464-471. doi: 10.1007/s00059-024-05251-4. Epub 2024 Jun 4.
The ratio of pulmonary artery diameter (PAD) to ascending aortic diameter (AoD) has been reported to be a prognostic marker in several lung diseases; however, the usefulness of this tool in patients with acute pulmonary embolism (APE) is unknown. Here, we aimed to determine the long-term prognostic value of the PAD/AoD ratio in patients with APE.
A total of 275 patients diagnosed with APE at our tertiary care center between November 2016 and February 2022 were included in the study. The patients were divided into two groups according to the presence of long-term mortality and their PAD/AoD ratios were compared.
Long-term mortality was observed in 48 patients during the median follow-up of 59 (39-73) months. The patients were divided into two groups for analysis: group 1, consisting of 227 patients without recorded mortality, and group 2, consisting of 48 patients with documented mortality. A multivariate Cox regression model indicated that the PAD/AoD ratio has the potential to predict long-term mortality (HR: 2.9116, 95% CI: 1.1544-7.3436, p = 0.023). Analysis of the receiver operating characteristic curve revealed that there was no discernible difference in discriminative ability between the simplified pulmonary embolism severity index (sPESI) and PAD/AoD ratio (area under the curve [AUC] = 0.679 vs. 0.684, respectively, p = 0.937). The long-term predictive ability of the PAD/AoD ratio was not inferior to the sPESI score.
The PAD/AoD ratio, which can be easily calculated from pulmonary computed tomography, may be a useful parameter for determining the prognosis of APE patients.
已有研究报道，肺动脉直径（PAD）与升主动脉直径（AoD）的比值（PAD/AoD 比）可作为多种肺部疾病的预后标志物；然而，该指标在急性肺栓塞（APE）患者中的应用价值尚不清楚。本研究旨在确定 PAD/AoD 比在 APE 患者中的长期预后价值。
本研究纳入了 2016 年 11 月至 2022 年 2 月在我院接受治疗的 275 例 APE 患者。根据患者是否存在长期死亡，将其分为两组，并比较两组的 PAD/AoD 比值。
在中位随访 59（39-73）个月期间，有 48 例患者发生长期死亡。将患者分为两组进行分析：组 1 包括 227 例无死亡记录的患者，组 2 包括 48 例有死亡记录的患者。多变量 Cox 回归模型表明，PAD/AoD 比可能预测长期死亡（HR：2.9116，95%CI：1.1544-7.3436，p=0.023）。受试者工作特征曲线分析表明，简化肺栓塞严重指数（sPESI）和 PAD/AoD 比的鉴别能力无明显差异（曲线下面积 [AUC]分别为 0.679 和 0.684，p=0.937）。PAD/AoD 比的长期预测能力不劣于 sPESI 评分。
PAD/AoD 比可通过肺部计算机断层扫描轻松计算，可能是评估 APE 患者预后的有用指标。
