The authors of a study published in Respiratory Medicine investigated the prognostic value of chest CT and heart contour changes on chest radiography (CXR) for predicting adverse outcomes in patients with idiopathic pulmonary arterial hypertension (IPAH). The investigators retrospectively analyzed the outcomes of 80 patients (mean age 42.6 years; 75% female). The study showed that adverse outcomes, including IPAH-related death or lung transplantation, were associated with factors such as cardiac arrest (HR, 11.67, P=0.02), elevated mean pulmonary artery pressure (HR, 1.04; P=0.001), and a reduced 6-minute walk distance (HR, 0.997; P=0.03). CT-derived right atrial (RA) volume index (HR, 1.01; P=0.02) and changes in RA contour on CXR (HR, 1.27; P<0.001) were significant predictors. A combined model of clinical, CT, and CXR parameters showed 82.2% predictive accuracy for 3-year event-free survival. The authors concluded that monitoring RA contour changes and RA volume index could help identify patients with IPAH at risk for poor outcomes.
