• Karthik Narendra Kumar, Naveen G Singh, Nagaraja P S, Thimmangouda A Patil, and Manjunath N.
• Department of Cardiac Anaesthesiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bangalore, India. Electronic address: karthiknarendrakumar@gmail.com.
• J. Cardiothorac. Vasc. Anesth. 2017 Oct 1; 31 (5): 1702-1706.

ObjectiveThe objective of the study was to investigate if the main pulmonary artery (mPA)-to-ascending aorta (AscAo), (mPA:AscAo) ratio could serve as a screening tool in identifying pulmonary artery hypertension (PAH).DesignA prospective observational study.SettingTertiary care center, university hospital.ParticipantsFifty-four adult patients undergoing off-pump coronary artery bypass grafting surgery (OPCAB).InterventionsmPA and AscAo transverse diameters were measured by transesophageal echocardiography (TEE) and the mean pulmonary arterial pressures (mPAP) were recorded simultaneously using a pulmonary artery catheter.Measurements And Main ResultsmPA:AscAo ratio demonstrated significant linear correlation with mPAP measured by pulmonary artery catheterization (ie, r = 0.61, confidence interval [CI] = 0.5352-0.6736, p < 0.0001). Receiver operating characteristic curves were performed to evaluate sensitivity and specificity of mPA:AscAo ratio ≥1 for diagnosing PAH (mPAP ≥25 mmHg). Area under the curve for mPA:AscAo ratio was 0.91 (95% CI, 0.869-0.936, p < 0.0001), with a sensitivity of 84.27%, specificity of 83.92%, positive-predictive value of 87.6% and negative-predictive value of 81.1% for a mPAP ≥25 mmHg.ConclusionsThe ratio of mPA:AscAo is a simple, reliable, and reproducible method that can be obtained through TEE, which guides the clinician to screen patients with PAH.Copyright © 2017 Elsevier Inc. All rights reserved.

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