The main pulmonary artery in adults: a controlled multicenter study with assessment of echocardiographic reference values, and the frequency of dilatation and aneurysm in Marfan syndrome
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The main pulmonary artery in adults: a controlled multicenter study with assessment of echocardiographic reference values, and the frequency of dilatation and aneurysm in Marfan syndrome. / Sheikhzadeh, Sara; De Backer, Julie; Gorgan, Neda Rahimian; Rybczynski, Meike; Hillebrand, Mathias; Schüler, Helke; Bernhardt, Alexander M; Koschyk, Dietmar; Bannas, Peter; Keyser, Britta; Mortensen, Kai; Radke, Robert M; Mir, Thomas S; Kölbel, Tilo; Robinson, Peter N; Schmidtke, Jörg; Berger, Juergen; Blankenberg, Stefan; Kodolitsch, Yskert.
in: ORPHANET J RARE DIS, Jahrgang 9, Nr. 1, 10.12.2014, S. 203.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - The main pulmonary artery in adults: a controlled multicenter study with assessment of echocardiographic reference values, and the frequency of dilatation and aneurysm in Marfan syndrome
AU - Sheikhzadeh, Sara
AU - De Backer, Julie
AU - Gorgan, Neda Rahimian
AU - Rybczynski, Meike
AU - Hillebrand, Mathias
AU - Schüler, Helke
AU - Bernhardt, Alexander M
AU - Koschyk, Dietmar
AU - Bannas, Peter
AU - Keyser, Britta
AU - Mortensen, Kai
AU - Radke, Robert M
AU - Mir, Thomas S
AU - Kölbel, Tilo
AU - Robinson, Peter N
AU - Schmidtke, Jörg
AU - Berger, Juergen
AU - Blankenberg, Stefan
AU - Kodolitsch, Yskert
PY - 2014/12/10
Y1 - 2014/12/10
N2 - BackgroundEchocardiographic upper normal limits of both main pulmonary artery (MPA) diameters (MPA-d) and ratio of MPA to aortic root diameter (MPA-r) are not defined in healthy adults. Accordingly, frequency of MPA dilatation based on echocardiography remains to be assessed in adults with Marfan syndrome (MFS).MethodsWe enrolled 123 normal adults (72 men, 52 women aged 42¿±¿14 years) and 98 patients with MFS (42 men, 56 women aged 39¿±¿14 years) in a retrospective cross-sectional observational controlled study in four tertiary care centers. We defined outcome measures including upper normal limits of MPA-d and MPA-r as 95 quantile of normal persons, MPA dilatation as diameters¿>¿upper normal limits, MPA aneurysm as diameters >4 cm, and indication for surgery as MPA diameters >6 cm.ResultsMPA diameters revealed normal distribution without correlation to age, sex, body weight, body height, body mass index and body surface area. The upper normal limit was 2.6 cm (95% confidence interval (CI) =2.44-2.76 cm) for MPA-d, and 1.05 (95% CI¿=¿.86¿1.24) for MPA-r. MPA dilatation presented in 6 normal persons (4.9%) and in 68 MFS patients (69.4%; P¿<¿.001), MPA aneurysm presented only in MFS (15 patients; 15.3%; P¿<¿.001), and no patient required surgery. Mean MPA-r were increased in MFS (P¿<¿.001), but ratios >1.05 were equally frequent in 7 normal persons (5%) and in 8 MFS patients (10.5%; P¿=¿.161). MPA-r related to aortic root diameters (P¿=¿.042), reduced left ventricular ejection fraction (P¿=¿.006), and increased pulmonary artery systolic pressures (P¿=¿.040). No clinical manifestations of MFS and no FBN1 mutation characteristics related to MPA diameters.ConclusionsWe established 2.6 cm for MPA-d and 1.05 for MPA-r as upper normal limits. MFS exhibits a high prevalence of MPA dilatation and aneurysm. However, patients may require MPA surgery only in scarce circumstances, most likely because formation of marked MPA aneurysm may require LV dysfunction and increased PASP.
AB - BackgroundEchocardiographic upper normal limits of both main pulmonary artery (MPA) diameters (MPA-d) and ratio of MPA to aortic root diameter (MPA-r) are not defined in healthy adults. Accordingly, frequency of MPA dilatation based on echocardiography remains to be assessed in adults with Marfan syndrome (MFS).MethodsWe enrolled 123 normal adults (72 men, 52 women aged 42¿±¿14 years) and 98 patients with MFS (42 men, 56 women aged 39¿±¿14 years) in a retrospective cross-sectional observational controlled study in four tertiary care centers. We defined outcome measures including upper normal limits of MPA-d and MPA-r as 95 quantile of normal persons, MPA dilatation as diameters¿>¿upper normal limits, MPA aneurysm as diameters >4 cm, and indication for surgery as MPA diameters >6 cm.ResultsMPA diameters revealed normal distribution without correlation to age, sex, body weight, body height, body mass index and body surface area. The upper normal limit was 2.6 cm (95% confidence interval (CI) =2.44-2.76 cm) for MPA-d, and 1.05 (95% CI¿=¿.86¿1.24) for MPA-r. MPA dilatation presented in 6 normal persons (4.9%) and in 68 MFS patients (69.4%; P¿<¿.001), MPA aneurysm presented only in MFS (15 patients; 15.3%; P¿<¿.001), and no patient required surgery. Mean MPA-r were increased in MFS (P¿<¿.001), but ratios >1.05 were equally frequent in 7 normal persons (5%) and in 8 MFS patients (10.5%; P¿=¿.161). MPA-r related to aortic root diameters (P¿=¿.042), reduced left ventricular ejection fraction (P¿=¿.006), and increased pulmonary artery systolic pressures (P¿=¿.040). No clinical manifestations of MFS and no FBN1 mutation characteristics related to MPA diameters.ConclusionsWe established 2.6 cm for MPA-d and 1.05 for MPA-r as upper normal limits. MFS exhibits a high prevalence of MPA dilatation and aneurysm. However, patients may require MPA surgery only in scarce circumstances, most likely because formation of marked MPA aneurysm may require LV dysfunction and increased PASP.
U2 - 10.1186/s13023-014-0203-8
DO - 10.1186/s13023-014-0203-8
M3 - SCORING: Journal article
C2 - 25491897
VL - 9
SP - 203
JO - ORPHANET J RARE DIS
JF - ORPHANET J RARE DIS
SN - 1750-1172
IS - 1
ER -