Dilatation of the main pulmonary artery in patients with isolated pulmonary stenosis: Arteriopathy or hemodynamic consequence?

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Pietro Paolo Tamborrino, Michela Miglianti, Dario Freitas, Camelia Demetrescu, Christopher Rush, Claudia Montanaro, Alessandra Frigiola
{"title":"Dilatation of the main pulmonary artery in patients with isolated pulmonary stenosis: Arteriopathy or hemodynamic consequence?","authors":"Pietro Paolo Tamborrino, Michela Miglianti, Dario Freitas, Camelia Demetrescu, Christopher Rush, Claudia Montanaro, Alessandra Frigiola","doi":"10.1016/j.jocmr.2025.101874","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Main pulmonary artery (mPA) dilatation has been reported in patients with isolated pulmonary valve (PV) stenosis. The aim of our study was to detect the incidence of mPA dilatation and aneurysm in patients with isolated PV stenosis and the association with PV function.</p><p><strong>Methods: </strong>In this single-centre retrospective observational study all patients with a diagnosis of isolated PV stenosis referred to our centre were enrolled. Patients were divided into two groups (children and adults) according to age. Echocardiography, cardiac magnetic resonance imaging (MRI) and computed tomography (CT) were reviewed. MPA dilatation was defined as ≥2 Z-Score in children and ≥30mm diameters in adults, while giant (aneurysmal) mPA dilatation was defined as ≥4 Z-Score in children and ≥40mm in adults.</p><p><strong>Results: </strong>Out of 197 patients (41.6% males, 51.8% children), 67.2% presented mPA dilatation and 16.8% giant dilatation of the mPA. The majority were adults (p<0.001). There was an underestimation of the mPA with echocardiography in 11% of patients with mPA dilatation and 50% with giant mPA. The diameter did not correlate with sex and the degree of PV stenosis. About 44% of cohort under follow-up presented a progression in mPA dilatation, however no rupture or cardiac-related death was reported.</p><p><strong>Conclusions: </strong>There is a very high incidence of mPA dilatation in both adults and paediatric patients with isolated PV stenosis. Nevertheless, there were not recorded dissections even in patients with the largest diameters suggesting a more benign lesion. Echocardiography often underestimates the mPA measurement compared to MRI/CT which might be indicated in selected patients as a baseline 3D cross-sectional imaging evaluation, even in the presence of mild PV disease, especially when the mPA is not well visualised.</p>","PeriodicalId":15221,"journal":{"name":"Journal of Cardiovascular Magnetic Resonance","volume":" ","pages":"101874"},"PeriodicalIF":4.2000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Magnetic Resonance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jocmr.2025.101874","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Main pulmonary artery (mPA) dilatation has been reported in patients with isolated pulmonary valve (PV) stenosis. The aim of our study was to detect the incidence of mPA dilatation and aneurysm in patients with isolated PV stenosis and the association with PV function.

Methods: In this single-centre retrospective observational study all patients with a diagnosis of isolated PV stenosis referred to our centre were enrolled. Patients were divided into two groups (children and adults) according to age. Echocardiography, cardiac magnetic resonance imaging (MRI) and computed tomography (CT) were reviewed. MPA dilatation was defined as ≥2 Z-Score in children and ≥30mm diameters in adults, while giant (aneurysmal) mPA dilatation was defined as ≥4 Z-Score in children and ≥40mm in adults.

Results: Out of 197 patients (41.6% males, 51.8% children), 67.2% presented mPA dilatation and 16.8% giant dilatation of the mPA. The majority were adults (p<0.001). There was an underestimation of the mPA with echocardiography in 11% of patients with mPA dilatation and 50% with giant mPA. The diameter did not correlate with sex and the degree of PV stenosis. About 44% of cohort under follow-up presented a progression in mPA dilatation, however no rupture or cardiac-related death was reported.

Conclusions: There is a very high incidence of mPA dilatation in both adults and paediatric patients with isolated PV stenosis. Nevertheless, there were not recorded dissections even in patients with the largest diameters suggesting a more benign lesion. Echocardiography often underestimates the mPA measurement compared to MRI/CT which might be indicated in selected patients as a baseline 3D cross-sectional imaging evaluation, even in the presence of mild PV disease, especially when the mPA is not well visualised.

孤立性肺动脉狭窄患者的主肺动脉扩张:动脉病变还是血流动力学后果?
背景:肺动脉主干(mPA)扩张在孤立性肺动脉瓣(PV)狭窄患者中有报道。我们的研究目的是检测孤立性PV狭窄患者的mPA扩张和动脉瘤的发生率及其与PV功能的关系。方法:在这项单中心回顾性观察研究中,所有被诊断为孤立性PV狭窄的患者都被纳入本中心。患者按年龄分为儿童和成人两组。对超声心动图、心脏磁共振成像(MRI)和计算机断层扫描(CT)进行了综述。儿童MPA扩张定义为Z-Score≥2,成人≥30mm;巨大(动脉瘤状)MPA扩张定义为Z-Score≥4,成人≥40mm。结果:197例患者(男性41.6%,儿童51.8%)中,67.2%表现为mPA扩张,16.8%表现为mPA巨大扩张。结论:成人和儿童孤立性PV狭窄患者的mPA扩张发生率非常高。然而,即使在直径最大的患者中也没有记录解剖,这表明病变更良性。与MRI/CT相比,超声心动图经常低估mPA测量值,这可能在特定患者中作为基线3D横断面成像评估,即使存在轻度PV疾病,特别是当mPA没有很好地显示时。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信