title: Pulmonary artery size as a predictor of outcomes in idiopathic pulmonary fibrosis.
abstract: IPF patients have heightened propensity for pulmonary hypertension, which portends a worse outcome. Presence of pulmonary hypertension may be reflected in an enlarged pulmonary artery. We investigated pulmonary artery size measured on high-resolution computed tomography (HRCT) as an outcome predictor in IPF.We retrospectively reviewed all IPF patients evaluated at a tertiary-care centre between 2008 and 2013. Pulmonary artery and ascending aorta diameters were measured from chest HRCT with pulmonary artery:ascending aorta diameter (PA:A) ratio calculations. Outcome analysis defined by either death or lung transplant based on pulmonary artery size and PA:A ratio over 60 months was performed. Independent effects of different variables on overall outcomes were evaluated using the Cox proportional hazards model.98 IPF patients with available HRCT scans had a mean pulmonary artery diameter and PA:A ratio of 32.8 mm and 0.94, respectively. Patients with a PA:A ratio >1 had higher risk of death or transplant compared with a PA:A ratio ≤1 (p<0.001). A PA:A ratio >1 was also an independent predictor of outcomes in unadjusted and adjusted outcomes analyses (hazard ratio 3.99, p<0.001 and hazard ratio 3.35, p=0.002, respectively).A PA:A ratio >1 is associated with worse outcomes in patients with IPF.
  
  
  
  A ratio measurement may assist in risk stratification and prognostication of IPF patients.
authors: Dept of Pulmonary and Critical Care, University of California San Diego, San Diego, CA, USA.
authors: Stephanie
authors: S
authors: Shin
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: Christopher S
authors: CS
authors: King
authors: Dept of Pulmonary and Critical Care, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: Nitin
authors: N
authors: Puri
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: Oksana A
authors: OA
authors: Shlobin
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: A Whitney
authors: AW
authors: Brown
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: Shahzad
authors: S
authors: Ahmad
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA.
authors: Nargues A
authors: NA
authors: Weir
authors: Advanced Lung Disease and Lung Transplant Program, Dept of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA steven.nathan@inova.org.
authors: Steven D
authors: SD
authors: Nathan
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000503:physiopathology; D008168:Lung / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012044:Regression Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity