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Prognostic value of main pulmonary artery diameter to ascending aorta diameter ratio in patients with advanced heart failure.

Acta Cardiologica 2021 January 28
OBJECTIVES AND BACKGROUND: In this study we assessed the prognostic value of main pulmonary artery diameter and its ratio to ascending aorta diameter (P/Ao ratio) in advanced heart failure patients.

METHODS: Patients with advanced heart failure who were candidates for heart transplantation were retrospectively evaluated. The clinical information, cardiac catheterisation results, and computed tomography images were gathered from institutional database system. The observed and predicted probabilities for survival were analysed in a nomogram.

RESULTS: The P/Ao ratio was found to be a strong predictor for MACE both in traditional multivariable Cox proportional hazard regression modelling (increase in P/Ao ratio per 2 SD, HR:2.72, 95% CI 1.14-6.48, p  = 0.024) and ridge regression analysis (increase in P/Ao ratio per 2SD, HR:3.45, 95% CI 1.53-7.74, p  = 0.003). Prediction model showed statistically significant correlation between the observed and predicted probabilities for 1-year survival.

CONCLUSION: In patients with advanced heart failure, computed tomography derived P/Ao ratio might be a prognostic predictor during follow up.

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