Patients with pulmonary arterial hypertension (PAH), 38% were found to have pulmonary artery aneurysms (PAA), and both the PAH time course and connective tissue disease were shown to modify the risk for PAA development, according to study results published in The American Journal of Cardiology.

Pulmonary Artery

Left ventricular end diastolic pressure (LVEDP) measurement with standard right heart catheterization (RHC) measurement should be used in some patients at risk for pulmonary hypertension (PH), according to a study published in CHEST. Researchers extracted clinical data and invasive hemodynamics from 2270 patients undergoing simultaneous right and left heart catheterization at Vanderbilt Hospital from 1984 to2008. 

The median age of participants was 63 years, 42% were obese, and the reasons for RHC were coronary artery disease (38%), valvular heart disease (18%), and congestive heart failure(16%). The goal was to examine the conflict between pulmonary artery wedge pressure (PAWP) and LVEDP in individuals at risk for PH.  

Aneurysm

An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall.Aneurysms are a result of a weakened blood vessel wall, and may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus (starting point) for clot formation (thrombosis) and embolization.  As an aneurysm increases in size, the risk of rupture increases, leading to uncontrolled bleeding. 

Clinical data were obtained from the hospital records of patients with PAH and were retrospectively evaluated to determine the prevalence and risk factors for the development of PAAs. The study population underwent a high-resolution thoracic imaging technique or magnetic resonance imaging (MRI) shortly after diagnosis.

The primary end point was to determine the detection rate of PAAs assessed by computed tomography or MRI in patients with PAH. The secondary end points were to detect predictors of PAA development and determine PAA's prognostic impact. Of the 200 patients with PAH, PAAs were detected in 77 (38%). PAAs were more frequently detected in patients with congenital heart disease and toxic oil syndrome (P =.002 for both), and less frequently detected in patients with connective tissue disease (P =.001).

Time-course PAH continued to be an independent risk factor for PAA (hazard ratio, 1.01; 95% CI, 1.002-1.019; P=.016) while connective tissue disease was associated with a lower risk for PAA (hazard ratio, 0.236; 95% CI, 0.060-0.920; P =.037).