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
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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?
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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.
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