Estimation of measured pulmonary artery to aorta ratio for prognosis of pulmonary hypertension in chronic obstructive pulmonary disease patients


  • Swetha Madas Department of TB & Respiratory Medicine, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India
  • D. Sai Vittal Department of Medicine, Mallareddy Institute of Medical Sciences, Hyderabad, Telangana, India



Chronic obstructive pulmonary disorder, Main pulmonary artery diameter, Ascending aorta diameter, MPA/AAo ratio


Background: Chronic obstructive pulmonary disease is a type of obstructive lung disease which is characterized by poor air flow to the lungs which worsens over time. Enlargement of the pulmonary artery is associated with the severe exacerbations of chronic obstructive pulmonary disease. Furthermore, it was indicated that MPA/AAo >1 could be an indicator to predict acute exacerbations of COPD. This study was thus undertaken to identify the association of MPA/AAo ratio and pulmonary hypertension by CT chest.

Methods: 157 patients with definite diagnosis of COPD and 50 patients without any cardiovascular disease or lung disease were included into the study. The patients were asked to lay down in left lateral position with calm breathing during the Doppler test for PH measurement; electrocardiogram and heart rate were also measured for all patients.

Results: Out of these 157 patients, 98 (62.4%) were males and 59 (37.6%) were females. Of the pulmonary artery diameter, the main, right and the left arterial diameter was considerably higher than that of the controls with 28.6, 21.8 and 21.5 mm respectively. There was no significant difference in the diameters of the ascending and the descending aorta between that of the patients and the controls. The ratio of MPA/AAo and MPA/DAo was higher in the patients that the controls. The MPA, LPA, RPA diameters were 30.3mm, 23.5mm and 23.2 mm in the patients with PH while they were significantly lesser in the COPD patients without PH. the most common comorbidities found was obesity, diabetes, dyslipidemia, stroke, abnormal CT findings, Emphysema, Fibrosis and Bronchiectasis with the MPA and AAo diameters significantly higher.

Conclusions: We conclude that a high MPA:AAo ratio correlated with increase in the MPA and AAo diameter and as a result, increased arterial pressure and presence of PH.


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