PAH Survival May Increase Risk for Pulmonary Artery Aneurysms

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Pulmonary artery aneurysms were more frequently detected in patients with congenital heart disease and toxic oil syndrome.
Pulmonary artery aneurysms were more frequently detected in patients with congenital heart disease and toxic oil syndrome.

Of patients with pulmonary arterial hypertension (PAH), 38% were found to have pulmonary artery aneurysms (PAA), and both the PAH time course and connective tissue disease were shown to modify the risk for PAA development, according to study results published in The American Journal of Cardiology.

Clinical data were obtained from the hospital records of patients with PAH and were retrospectively evaluated to determine the prevalence and risk factors for the development of PAAs. The study population underwent a high-resolution thoracic imaging technique or magnetic resonance imaging (MRI) shortly after diagnosis.

The primary end point was to determine the detection rate of PAAs assessed by computed tomography or MRI in patients with PAH. The secondary end points were to detect predictors of PAA development and determine PAA's prognostic impact.

Of the 200 patients with PAH, PAAs were detected in 77 (38%). PAAs were more frequently detected in patients with congenital heart disease and toxic oil syndrome (P =.002 for both), and less frequently detected in patients with connective tissue disease (P =.001). Time-course PAH continued to be an independent risk factor for PAA (hazard ratio, 1.01; 95% CI, 1.002-1.019; P =.016) while connective tissue disease was associated with a lower risk for PAA (hazard ratio, 0.236; 95% CI, 0.060-0.920; P =.037).

“Based on these findings, PAA development may be a consequence of long-term PAH, appearing in those pulmonary arterial hypertension patients with a longer survival,” the researchers wrote. “Compared with patients without PAA, PAA patients showed lower rates of the composite end point death and lung transplant during follow-up, but nonsignificant higher rates of sudden death.”

Reference

Nuche J, Cabezas J-MM, López-Guarch CJ, et al. Frequency, predictors, and prognostic impact of pulmonary artery aneurysms in patients with pulmonary arterial hypertension [published November 6, 2018]. Am J Cardiol. doi:10.1016/j.amjcard.2018.10.028

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