Relationship Between the Pulmonary Artery Index and Physiological Properties of the Pulmonary Vascular Bed

Senzaki, Hideaki; Kato, Hitoshi; Akagi, Michio; Hishi, Toshio; Yamaguchi, Masayoshi

doi:10.1253/jcj.60.334

Cited by 7 publications

(7 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This confirms previous findings from the landmark studies in the field [3,4,32,[50][51][52][53][54][55].…”

Section: Resistance-compliance Relationship Of the Pulmonary Circulationsupporting

confidence: 91%

“…Using the semi-logarithmic method (table 2), the recovered RC-time averaged 0.16-0.39 s in normal subjects but was higher in those with PH, averaging 0.21-0.83 s (table 2) [32, [51][52][53][54][55]. The shorter RC-times derived from the semi-logarithmic method would be more consistent with more complete expression of the Windkessel function compared with RC-times calculated from empiric estimates.…”

Section: Conflicting Results On Rc-time Value In Health and Diseasesmentioning

confidence: 91%

See 1 more Smart Citation

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

et al. 2015

View full text Add to dashboard Cite

Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent studies have popularised the concept that their product (RC-time of the pulmonary circulation, in seconds) is "constant" in health and diseases. However, emerging evidence suggests that this concept should be challenged, with shortened RC-times documented in post-capillary PH and normotensive subjects. Furthermore, reported RC-times in the literature have consistently demonstrated significant scatter around the mean. In precapillary PH, the true PVR can be overestimated if one uses the standard PVR equation because the zero-flow pressure may be significantly higher than pulmonary arterial wedge pressure. Furthermore, SV/PApp may also overestimate true C. Further studies are needed to clarify some of the inconsistencies of pulmonary RC-time, as this has major implications for our understanding of the arterial load in diseases of the pulmonary circulation. @ERSpublications Empiric estimates of pulmonary arterial load are prone to errors and may result in overestimation of RC-time

show abstract

“…This confirms previous findings from the landmark studies in the field [3,4,32,[50][51][52][53][54][55].…”

Section: Resistance-compliance Relationship Of the Pulmonary Circulationsupporting

confidence: 91%

Section: Conflicting Results On Rc-time Value In Health and Diseasesmentioning

confidence: 91%

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

et al. 2015

View full text Add to dashboard Cite

show abstract

“…TRADITIONALLY, PULMONARY ANGIOGRAPHY has been used to determine the presence and possible hemodynamic significance of residual branch pulmonary arterial stenoses after surgical repair of congenital heart diseases (CHDs) (1, 2). Assessment of morphology of pulmonary arteries is still used widely for assigning hemodynamic significance of stenoses and the need for angioplasty or stenting (3–5). However, rheological principles would suggest that proportional reductions in diameter or ratio of right and left pulmonary arterial diameters may give incomplete insight into the effect on blood flow since resistance to flow is related to the fourth power of the diameter of the vessel.…”

mentioning

confidence: 99%

“…However, rheological principles would suggest that proportional reductions in diameter or ratio of right and left pulmonary arterial diameters may give incomplete insight into the effect on blood flow since resistance to flow is related to the fourth power of the diameter of the vessel. Moreover, the total area of the peripheral pulmonary bed also importantly influences flow to each lung (5). In spite of these physiological considerations, the morphologic appearance of a stenosis, especially the degree of maximum stenosis, has been substantially relied upon for management decisions.…”

mentioning

confidence: 99%

Disparity between ratios of diameters and blood flows in central pulmonary arteries in postoperative congenital heart disease using MRI

Ordovás

Tan

Reddy

et al. 2007

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose:To compare the relative severity of stenoses of right or left pulmonary arteries with differences in flow to each lung after repair of congenital heart disease (CHD). Materials and Methods:A total of 15 patients with postoperative congenital heart disease underwent MRI to evaluate branch pulmonary artery stenoses. Spin-echo images and MR angiography were used to assess morphology, and velocity-encoded cine (VEC) MRI was used to measure flow in the right and left pulmonary arteries. The ratios of the narrowest diameters of the right to left pulmonary arteries (R/L size) and right to left pulmonary arterial flow (R/L flow) were compared using Spearman's correlation. F test was used to assess the significance of the regression coefficients.Results: R/L size ratio varied from 0.50 to 2.66, while the R/L flow ratio varied from 0.36 to 12.02. There was an exponential relationship between R/L size and R/L flow, with r 2 ϭ 0.78 and P ϭ 0.001. However, severity of morphologic stenoses was not clinically useful for predicting flow reduction. Prediction residuals ranged from -136% to 54% of the true R/L flow. Conclusion:Anatomical evaluation of the pulmonary arteries does not predict accurately differential blood flow in patients with pulmonary stenoses. Therefore, blood flow measurements are essential when considering the need for further surgical or interventional procedures.

show abstract

“…Nakata and colleagues 25 first introduced a quantitative method to estimate the indexed cross‐sectional areas of both pulmonary arteries (PAI) to predict the postoperative prognosis of the patients with congenital heart disease with reduced pulmonary blood flow. The PAI is not presently used to determine the reparability of congenital heart disease, because this index does not always reflect the effect of the peripheral pulmonary vascular bed, especially in cases with the disproportional development of central and peripheral pulmonary arteries 26,27 . In this study, we used this index to estimate the pulmonary arterial growth after restoration of the pulmonary blood flow.…”

Section: Commentmentioning

confidence: 99%

Symptomatic Young Infants with Tetralogy of Fallot: One-stage versus Staged Repair

Park

Kim

Bae

et al. 2010

Journal of Cardiac Surgery

View full text Add to dashboard Cite

show abstract

Relationship Between the Pulmonary Artery Index and Physiological Properties of the Pulmonary Vascular Bed

Abstract: PAI reflects the state of the pulmonary vascular bed, especially when the peripheral arteries develop in proportion to the central pulmonary artery.

Cited by 7 publications

References 6 publications

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension

Disparity between ratios of diameters and blood flows in central pulmonary arteries in postoperative congenital heart disease using MRI

Symptomatic Young Infants with Tetralogy of Fallot: One-stage versus Staged Repair

Contact Info

Product

Resources

About