What is the clinical evidence from this study?

Study design: Cohort. Population: Severe aortic stenosis undergoing TAVI (n=526). Intervention: CT-derived main pulmonary artery to ascending aorta (MPA/AA) ratio vs. MPA/AA < 0.76. Primary outcome: Overall long-term survival (all-cause mortality) (HR 1.857, 95% CI 1.190-2.898, p=0.006).

What question did this study set out to answer?

To evaluate the predictive value of pulmonary artery metrics for pulmonary hypertension and survival post-TAVI, considering sex differences.

April 10, 2026Open Access

Sex-specific utility of pulmonary artery metrics in predicting pulmonary hypertension and survival after TAVI: insights from advanced CT imaging

Q: What are the key findings of this study?

An elevated main pulmonary artery to ascending aorta ratio (≥ 0.76) predicted worse long-term survival exclusively in male patients undergoing TAVI (HR 1.857), showing no prognostic value in females.

Q: What question did this study set out to answer?

To evaluate the predictive value of pulmonary artery metrics for pulmonary hypertension and survival post-TAVI, considering sex differences.

Key Result

An elevated main pulmonary artery to ascending aorta ratio (≥ 0.76) predicted worse long-term survival exclusively in male patients undergoing TAVI (HR 1.857), showing no prognostic value in females.

Key Points

To evaluate the predictive value of pulmonary artery metrics for pulmonary hypertension and survival post-TAVI, considering sex differences.
Utilized advanced CT imaging to assess pulmonary artery metrics.
Analyzed the pulmonary artery to AA ratio in men and women undergoing TAVI procedures.
Compared survival outcomes related to pulmonary artery metrics based on sex.
The pulmonary artery to AA ratio predicted survival in men but not in women.
Sex-specific imaging assessments improved risk stratification for men.
The findings highlight the need for different diagnostic strategies for men and women.

Study Design

Type

Cohort

Multicenter

Structured PICO

Does the pulmonary artery to ascending aorta ratio assessed by CT imaging predict survival and pulmonary hypertension after TAVI in a sex-specific manner?

Population

Patients undergoing Transcatheter Aortic Valve Implantation (TAVI)

Intervention

Advanced CT imaging assessment of pulmonary artery to ascending aorta (AA) ratio

Outcome

Survival and prediction of pulmonary hypertensionhard clinical

Sex-specific imaging assessments, specifically the pulmonary artery to ascending aorta ratio, improve risk stratification for survival after TAVI in men but not women.

Limitations

Retrospective, single-center design introducing potential selection bias
Lack of invasive hemodynamic confirmation by right heart catheterization
Potential residual misclassification of pulmonary hypertension etiology
Unmeasured confounding factors such as frailty and comorbidities
Lack of cause-specific mortality data

Abstract

PH impacts TAVI outcomes, yet sex-specific radiological predictors remain insufficiently investigated. The pulmonary artery to AA ratio predicted survival in men but showed no prognostic value for women. Implementing sex-specific imaging assessments improves risk stratification in men, highlighting the need for distinct diagnostic strategies for women.

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Discussion

Authors

Elke Boxhammer

Matthias Hammerer

Nikolaos Schörghofer

Journals

Insights into Imaging

Actions

Institutions

University of Salzburg

Paracelsus Medical University

References and Citations

Connected Papers

Building similarity graph...

Analyzing shared references across papers

Sex-specific utility of pulmonary artery metrics in predicting pulmonary hypertension and survival after TAVI: insights from advanced CT imaging

Key Result

Key Points

Study Design

Structured PICO

Limitations

Abstract

Citation Network

Connected Papers

Discussion

Authors

Journals

Actions

Institutions

References and Citations

Citation Network

Connected Papers

Discussion

Cite this study