Background
Methods
Study design
Measurements
Statistical analysis
Results
Baseline characteristics
Clinical characteristics | n = 303 |
---|---|
Age, years | 67.2 ± 9.5 |
Male sex | 234 (77.2%) |
BMI, kg/m2, median (IQR) | 22.7 (20.1–24.9) |
Ever-smoker | 211 (69.6%) |
Smoking, pack-years, median (IQR) | 30.0 (20.0–42.0) |
Underlying disease | |
Hypertension | 100 (33.0%) |
Diabetes mellitus | 88 (29.0%) |
Pulmonary tuberculosis | 43 (13.2%) |
Emphysema | 39 (12.9%) |
Ischemic heart disease | 29 (9.6%) |
Congestive heart failure | 10 (3.3%) |
GAP score, median (IQR) | 3.0 (2.0–4.0) |
6MWD, m, median (IQR) | 400.0 (308.5–480.0) (N = 152) |
Pulmonary function at diagnosis | |
FVC, %, median (IQR) | 74.0 (59.0–86.0) |
FEV1, %, median (IQR) | 88.0 (71.0–100.0) |
FEV1/FVC, %, median (IQR) | 83.0 (77.8–89.0) |
DLCO, % | 69.0 (51.0–86.0) |
Echocardiography | |
Ejection fraction %, median (IQR) | 66.0 (61.0–70.0) (N = 196) |
Right ventricular pressure, mmHg, median (IQR) | 28.0 (28.0–47.0) (N = 163) |
Chest CT | |
mPA diameter, mm, median (IQR) | 27.9 (26.1–30.5) |
Ascending Ao diameter, mm, median (IQR) | 34.2 (31.6–36.7) |
mPA/Ao ratio, median (IQR) | 0.83 (0.77–0.90) |
Clinical characteristics according to mPA/Ao ratio
Clinical factors | mPA/Ao ratio | Univariable analysis | Multivariable analysis | |||||
---|---|---|---|---|---|---|---|---|
≤1 (n = 272) | > 1 (n = 31) | OR | 95% CI |
P
| OR | 95% CI |
P
| |
Age, years | 67.9 ± 9.1 | 60.4 ± 10.0 | 0.92 | 0.89–0.96 | < 0.001 | |||
Sex, male | 215 (79.0%) | 19 (61.3%) | 2.38 | 1.09–5.19 | 0.029 | |||
BMI, kg/m2 (median, IQR) | 22.7 (20.2–24.9) | 22.5 (19.1–26.2) | 1.01 | 0.91–1.12 | 0.848 | |||
Ever-smoker | 194 (71.9%) | 17 (54.8%) | 0.48 | 0.22–1.01 | 0.054 | |||
Underlying disease | ||||||||
Hypertension | 94 (34.6%) | 6 (19.4%) | 0.45 | 0.18–1.15 | 0.095 | |||
Diabetes mellitus | 82 (30.1%) | 6 (19.4%) | 0.56 | 0.22–1.41 | 0.215 | |||
Pulmonary tuberculosis | 41 (15.1%) | 2 (6.5%) | 0.39 | 0.09–1.69 | 0.208 | |||
Emphysema | 37 (13.7%) | 2 (6.5%) | 0.44 | 0.10–1.91 | 0.270 | |||
Ischemic heart disease | 28 (10.3%) | 1 (3.2%) | 0.29 | 0.04–2.21 | 0.233 | |||
Congestive heart failure | 10 (3.7%) | 0 (0%) | ||||||
GAP score | 3.11 ± 1.24 | 3.75 ± 1.26 | 1.57 | 1.08–2.27 | 0.018 | 1.53 | 0.69–3.40 | 0.298 |
6 MW distance, m (median, IQR) | 410.0 (322.5–480.0) | 232.5 (95.0–555.8) | 0.99 | 0.99–1.00. | 0.032 | 0.99 | 0.99–1.00 | 0.190 |
PFT at diagnosis | ||||||||
FVC, % predicted, (median, IQR) | 75.0 (61.0–86.3) | 55.0 (44.5–72.0) | 0.95 | 0.93–0.98 | < 0.001 | |||
FEV1, % predicted, (median, IQR) | 89.5 (73.0–100.0) | 64.0 (51.5–81.0) | 0.96 | 0.95–0.98 | < 0.001 | 1.07 | 0.99–0.15 | 0.074 |
DLCO, % | 70.9 ± 23.8 | 48.4 ± 23.1 | 0.96 | 0.94–0.98 | < 0.001 | |||
Echocardiography | ||||||||
EF, %, (median, IQR) | 65.0 (61.0–69.0) | 67.0 (64.0–71.0) | 1.08 | 1.01–1.14 | 0.022 | 1.09 | 0.93–1.27 | 0.285 |
RVP, mmHg, (median, IQR) | 37.0 (27.8–46.0) | 43.0 (33.0–52.5) | 1.03 | 1.01–1.06 | 0.014 | 1.04 | 0.99–1.10 | 0.113 |
Chest CT | ||||||||
mPA diameter, mm, (median, IQR) | 27.6 (25.8–29.8) | 32.9 (29.8–35.1) | 1.38 | 1.23–1.54 | < 0.001 | |||
Ascending Ao diameter, mm, (median, IQR) | 34.5 (32.0–36.9) | 29.8 (27.7–32.8) | 0.71 | 0.62–0.80 | < 0.001 |
Clinical factors | mPA/Ao ratio | Univariate analysis | Multivariate analysis | |||||
---|---|---|---|---|---|---|---|---|
≤ 0.8 (n = 121) | > 0.8 (n = 182) | OR | 95% CI |
P
| OR | 95% CI |
P
| |
Age, years | 68.7 ± 8.3 | 66.1 ± 10.0 | 0.97 | 0.95–1.00 | 0.019 | 0.96 | 0.91–1.01 | 0.136 |
Sex, male | 102 (84.3%) | 132 (72.5%) | 2.03 | 1.13–3.66 | 0.018 | |||
BMI, kg/m2, (median, IQR) | 23.2 (20.8–26.6) | 22.4 (19.8–24.8) | 0.96 | 0.91–1.03 | 0.247 | |||
Ever-smoker | 91 (75.8%) | 120 (66.3%) | 0.63 | 0.37–1.05 | 0.078 | |||
Underlying disease | ||||||||
Hypertension | 40 (33.1%) | 60 (33.0%) | 1.00 | 0.61–1.62 | 0.987 | |||
Diabetes mellitus | 30 (24.8%) | 58 (31.9%) | 1.42 | 0.85–2.38 | 0.185 | |||
Pulmonary tuberculosis | 15 (12.4%) | 28 (15.4%) | 1.29 | 0.66–2.52 | 0.466 | |||
Emphysema | 19 (15.7%) | 20 (11.0%) | 0.67 | 0.34–1.31 | 0.240 | |||
Ischemic heart disease | 8 (6.6%) | 21 (11.5%) | 1.84 | 0.79–4.31 | 0.158 | |||
Congestive heart failure | 2 (1.7%) | 8 (4.4%) | 2.74 | 0.57–13.1 | 0.208 | |||
GAP score | 3.07 ± 1.16 | 3.24 ± 1.31 | 1.12 | 0.91–1.37 | 0.280 | |||
6 MW distance, m (median, IQR) | 415.0 (356.3–477.5) | 400.0 (246.3–480.0) | 0.99 | 0.99–1.00 | 0.107 | |||
PFT at diagnosis | ||||||||
FVC, % predicted, (median, IQR) | 77.0 (63.0–90.5) | 71.0 (55.0–83.0) | 0.98 | 0.96–0.99 | < 0.001 | 1.01 | 0.97–1.05 | 0.735 |
FEV1, % predicted, (median, IQR) | 94.0 (76.0–101.0) | 83.0 (66.0–98.5) | 0.98 | 0.97–0.99 | < 0.001 | 1.01 | 0.97–1.04 | 0.805 |
DLCO, % | 77.1 ± 23.6 | 62.7 ± 23.6 | 0.97 | 0.96–0.99 | < 0.001 | 0.97 | 0.95–0.99 | 0.002 |
Echocardiography | ||||||||
EF, %, (median, IQR) | 64.0 (60.0–69.0) | 66.0 (62.0–70.0) | 1.02 | 0.99–1.05 | 0.294 | 1.16 | 0.93–1.45 | 0.187 |
RVP, mmHg, (median, IQR) | 34.4 (25.0–43.0) | 40.0 (31.5–48.0) | 1.03 | 1.00–1.05 | 0.038 | 1.01 | 0.98–1.05 | 0.485 |
Chest CT | ||||||||
mPA diameter, mm, (median, IQR) | 26.3 (24.5–27.9) | 29.7 (27.1–31.9) | 1.49 | 1.34–1.65 | < 0.001 | |||
Ascending aorta diameter, mm, (median, IQR) | 35.7 (33.9–37.7) | 32.7 (30.4–35.0) | 0.75 | 0.69–0.82 | < 0.001 |
Outcomes of IPF and associated risks
Variable | Hazard ratio | 95% CI | P-value |
---|---|---|---|
BMI, kg/m2 | 0.925 | 0.887–0.965 | < 0.001 |
GAP score | 1.676 | 1.218–2.306 | 0.002 |
mPA/Ao ratio | 3.062 | 1.849–5.071 | < 0.001 |