Pulmonary Artery Dilatation Is a Common Finding in a Coronary Artery CT Angiography Population

Abstract

Background/Aim: Dilatation of the main pulmonary artery (mPA) is a common incidental finding in chest imaging and often leads to consultation. The aim of this study was to determine the prevalence of mPA dilatation in a coronary artery CT angiography (CCTA) population. Patients and Methods: The study investigated 985 consecutive patients scheduled for diagnostic CCTA. The transverse axial diameter of the mPA was measured. The prevalence of mPA dilatation was estimated using different reference values (Framingham Heart Study: 28.9 mm for males and 26.9 mm for females, Bozlar: 29.5 mm for both genders and Karazincir: 32.6 mm for males and 31.9 mm for females). Results: The patient mean age was 53.0±9.7 years (66.5% were women). Body surface area (BSA) correlated moderately with the mPA diameter (r=0.423, p<0.001). The prevalence of mPA dilatation varied from 5.9% (Karazincir) to 33.7% (Framingham Heart Study) in the overall study population. Conclusion: The prevalence of mPA dilatation is high in a CCTA patient population when using a cut-off value from the Framingham Heart Study.

Pulmonary Artery Dilatation Due to Pressure or Volume Overload in Congenital Heart Disease

“…In our study, we also found a significant correlation between the MPA diameter and age (in all analyzed groups), which in other studies was not always the case. The explanation may be due to the very wide time span of the analyzed subjects in our study, from adolescence and young adulthood to older age (late seventies), compared to other studies, where usually only mid-aged to older population groups were described [ 21 , 24 ]. The age-related progression of the MPA size in our study may be associated not only with the longer period of pathological hemodynamics present in the patients but also with the natural increase in weight in the population throughout the years, as well as some increase in systemic and pulmonary blood pressure with time.…”

“…Most studies consider a normal MPA size of <28.9 mm for males and <26.9 mm for females based on the Framingham Heart Study [ 1 ] or the upper limit of 29–30 mm without distinguishing between genders [ 18 , 19 ]. On the other hand, there were also several other studies published with significantly lower or higher upper normal limits, varying from 25–26 mm [ 16 , 20 ] up to 32–33 mm [ 17 , 18 , 21 , 22 , 23 ].…”

“…The correlation of the MPA diameter with the patient’s body constitution is a well-known fact in all comparative studies [ 4 , 18 , 21 ], though a cut-off value indexing the MPA size to height, weight, or the patient’s body surface area still does not exist.…”