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Pulmonary artery enlargement during AE of f-ILD predicts poor survival outcome

27 Jul 2019

A pulmonary artery diameter to ascending aorta diameter ratio (PA/A) ≥1 during acute exacerbation (AE) is a predictor of poor survival outcomes in patients with fibrotic interstitial lung disease (f-ILD), suggest the results of a recent study.

“To the best of our knowledge, this is the first longitudinal examination of the PA/A ratio and evaluation during AE of f‐ILD,” the investigators claimed.

Forty-five of the 123 patients included had PA/A ≥1 during AE. Compared to the PA/A <1, these patients were younger, had lower % vital capacity (VC) and % forced vital capacity (FVC), required more long-term oxygen therapy and other treatment, and had lower PaO2/FiO2 (P/F) ratios.

PA/A during AE increased compared with that during stable periods (p<0.001). Moreover, PA/A ≥1 significantly correlated with 90-day mortality both before and after adjustment for age, the P/F ratio at admission, long-term oxygen therapy usage and the type of background f-ILD (p=0.018 and 0.025).

This study included patients with a diagnosis of AE of f-ILD and with a computed tomography (CT) scan performed during stable period to confirm background fibrosis, as well as a CT scan at admission. CT during and prior (when available) to AE were used to measure the pulmonary arterial diameter, ascending aortic diameter and PA/A so as to assess the changes. Demographic data, comorbidities and clinical outcome (90-day mortality) were analysed.

“In f‐ILD, PA/A ≥1 during the stable stage is associated with worse outcomes,” the investigators noted, “[but] the effect of AE on the PA/A is unknown.”

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Most Read Articles
5 days ago
Older women with longer endogenous oestrogen exposure and hormone therapy use are at much higher odds of having favourable cognitive status in late life, a recent study suggests.
3 days ago
In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), rivaroxaban monotherapy is noninferior to combination treatment with an antiplatelet therapy in terms of cutting the risk of cardiovascular events and mortality, according to data from the AFIRE trial.
Elvira Manzano, 4 days ago
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Jairia Dela Cruz, Yesterday
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