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- Title
Computed tomography-measured pulmonary artery to aorta ratio and EUTOS score for detecting dasatinib-induced pulmonary arterial hypertension.
- Authors
Toya, Takumi; Nagatomo, Yuji; Kagami, Kazuki; Yukino, Midori; Yasuda, Risako; Namba, Takayuki; Ido, Yasuo; Kobayashi, Shinichi; Masaki, Nobuyuki; Yada, Hirotaka; Kimura, Fumihiko; Adachi, Takeshi
- Abstract
<bold>Background: </bold>Periodic echo-based screening to detect early stages of a rare complication of dasatinib, pulmonary arterial hypertension (PAH), is inefficient and weakens the potential benefit of dasatinib as a potent drug for chronic myelogenous leukemia (CML). This study aimed to identify the predisposing factors of DASA-PAH to stratify high-risk patients for dasatinib-induced PAH (DASA-PAH).<bold>Methods: </bold>Sixty consecutive adult patients who received dasatinib were enrolled in this case-control study. We defined DASA-PAH when at least one of the following four criteria was met: (1) recent electrocardiographic changes indicating right ventricular pressure overload, (2) estimated systolic pulmonary arterial pressure > 40 mmHg measured by Doppler echocardiography; (3) computed tomography (CT)-measured pulmonary artery to aorta diameter (PaD/AoD) ratio > 1; and (4) mean pulmonary arterial pressure > 25 mmHg and pulmonary artery wedge pressure < 15 mmHg measured by right heart catheterization.<bold>Results: </bold>We identified 13 patients with DASA-PAH among 59 patients analyzed. Baseline PaD/AoD ratios of patients who developed DASA-PAH (PH group) were significantly larger than those who did not (NPH group). A dramatic rise in PaD/AoD ratio after dasatinib treatment was observed. Interestingly, the EUTOS score and spleen size were significantly smaller in the PH than in the NPH group.<bold>Conclusion: </bold>High baseline PaD/AoD ratio and low EUTOS score were associated with DASA-PAH development. The spleen might play a protective role against DASA-PAH.
- Subjects
PULMONARY artery; PULMONARY hypertension; CHRONIC myeloid leukemia; PULMONARY valve; DOPPLER echocardiography; AORTA; DASATINIB
- Publication
International Journal of Cardiovascular Imaging, 2019, Vol 35, Issue 8, p1435
- ISSN
1569-5794
- Publication type
journal article
- DOI
10.1007/s10554-019-01548-2