The Journal of Practical Medicine >

2025 , Vol. 41 >Issue 7: 960 - 967

DOI: https://doi.org/10.3969/j.issn.1006-5725.2025.07.005

Clinical Research

Effect of pulmonary artery to aorta diameter ratio on prognosis in patients with acute decompensated heart failure

  • Chunmei MA ,
  • Zhikang WU ,
  • Ke CHEN ,
  • Ziyan WANG ,
  • Yu WANG ,
  • Lian WANG
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  • *.Department of Cardiology，Nanjing Drum Tower Hospital Clinical College of Jiangsu University，Nanjing 210008，Jiangsu，China

Received date: 2024-12-26

  Online published: 2025-04-23

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Abstract

Objective To investigate the predictive value of pulmonary artery （Pa） to aortic （Ao） diameter ratio （Pa/Ao） for long?term major adverse cardiovascular events （MACEs） in patients with acute decompensated heart failure （ADHF）. Methods ADHF patients hospitalized in the Department of Cardiology of Nanjing Drum Tower Hospital from January 2018 to January 2023 were consecutively enrolled. The data of gender， age， past medical history， laboratory examination， echocardiography， chest CT and medication were collected. The diameters of Pa and Ao were measured at the bifurcation of main pulmonary artery on chest CT， and Pa/Ao was calculated. The Kaplan?Meier method was used for survival analysis， and the Log?rank test was used to compare the survival rate between the two groups. Cox proportional hazards regression model was used to analyze the association between Pa/Ao and MACEs， and subgroup analysis was performed according to different age， sex， BMI， B?type natriuretic peptide level， and left ventricular ejection fraction. Results A total of 600 ADHF patients were enrolled， with an average age of 69.6 years and 347（57.8%） males. During a median follow?up of 306（127，624） days， 327（54.5%） patients experienced MACEs. The ADHF patients were divided into Pa/Ao < 0.93 group and Pa/Ao≥0.93 group according to the analysis of maximum selection rank statistics. Kaplan?Meier curve showed that the incidence of MACEs in Pa/Ao ≥ 0.93 group was significantly higher than that in Pa/Ao < 0.93 group （PLog?rank < 0.001）. Multivariate Cox regression analysis showed that Pa/Ao was an independent predictor of MACEs in ADHF patients （HR = 11.62， 95%CI： 4.91 ~ 27.50， P < 0.001）. Subgroup analysis showed that Pa/Ao had predictive value for different ADHF populations （all P < 0.05）. Conclusion Elevated Pa/Ao is a predictor of long?term MACEs in ADHF patients.

Key words： acute decompensated heart failure; pulmonary artery to aorta diameter ratio; CT examination; prognosis

Cite this article

Chunmei MA , Zhikang WU , Ke CHEN , Ziyan WANG , Yu WANG , Lian WANG . Effect of pulmonary artery to aorta diameter ratio on prognosis in patients with acute decompensated heart failure[J]. The Journal of Practical Medicine, 2025 , 41(7) : 960 -967 . DOI: 10.3969/j.issn.1006-5725.2025.07.005

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