Hoarseness as a Predictor for Pulmonary Arterial Aneurysm and Extrinsic Left Main Coronary Artery Compression in Patients with Severe Pulmonary Hypertension

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dc.authoridHakgor, Aykun/0000-0001-8252-0373
dc.authoridKultursay, Barkin/0000-0002-1424-2209
dc.authoridTANYERİ ÜZEL, SEDA/0000-0002-0933-9233
dc.authoridTosun, Ayhan/0000-0001-9035-8839
dc.contributor.authorTokgoz, Hacer Ceren
dc.contributor.authorTanyeri, Seda
dc.contributor.authorSekban, Ahmet
dc.contributor.authorHakgor, Aykun
dc.contributor.authorKultursay, Barkin
dc.contributor.authorKeskin, Berhan
dc.contributor.authorKaragoz, Ali
dc.date.accessioned2024-09-11T19:53:25Z
dc.date.available2024-09-11T19:53:25Z
dc.date.issued2023
dc.departmentİstanbul Gelişim Üniversitesien_US
dc.description.abstractObjective: Pulmonary artery (PA) enlargement is a common finding in patients with severe pulmonary hypertension (PH) and may be associated with extrinsic compression of the left main coronary artery (LMCA-Co) and/or compression of the left recurrent laryngeal nerve resulting in hoarseness named as Ortner syndrome (OS). In this study, we evaluated the diagnostic impact of OS in predicting the PA aneurysm and significant LMCA-Co in patients with PH.Methods: Our study population comprised retrospectively evaluated 865 with PH confirmed with the right heart catheterization between 2006 and 2022. Patients underwent coronary angiography due to several indications, including the presence of a PA aneurysm on echocardiography, angina symptoms, or the incidental discovery of LMCA-Co on multidetector computed tomography. The LMCA-Co is defined as diameter stenosis 3 50% in reference distal LMCA segment on two consecutive angiographic planes.Results: The LMCA-Co and hoarseness were documented in 3.8% and 4.3% of patients with PH, respectively. Increasing PA diameter was significantly associated with worse clinical, hemodynamic, laboratory, and echocardiographic parameters. The receiver operating curves revealed that the PA diameter >41 mm was cutoff for hoarseness (AUC: 0.834; sensitivity 69%, specificity 84%, and negative predictive value 98%), and PA diameter >35 mm was cutoff for LMCA-Co >50% (AUC: 0.794; sensitivity 89%, specificity 58 %, and negative predictive value 99%). An odds ratio of hoarseness for LMCA-Co was 83.3 (95% confidence interval; 36.5-190, P < 0.001) with 3.2% sensitivity, 98.7% specificity, and 59% positive and 98% negative predictive values.Conclusion: In this study, a close relationship was found between the presence of hoarseness and the probability of extrinsic LMCA-Co by enlarged PA in patients with severe PH. Therefore, the risk of LMCA-Co should be taken into account in patients with PH suffering from hoarseness.en_US
dc.identifier.doi10.5543/tkda.2023.63828
dc.identifier.endpage454en_US
dc.identifier.issn1016-5169
dc.identifier.issn1308-4488
dc.identifier.issue7en_US
dc.identifier.pmid37861257en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.startpage447en_US
dc.identifier.urihttps://doi.org/10.5543/tkda.2023.63828
dc.identifier.urihttps://hdl.handle.net/11363/8134
dc.identifier.volume51en_US
dc.identifier.wosWOS:001125255000001en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherKare Publen_US
dc.relation.ispartofTurk Kardiyoloji Dernegi Arsivi-Archives of The Turkish Society of Cardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240903_Gen_US
dc.subjectEuphratesen_US
dc.subjecthoarsenessen_US
dc.subjectleft main coronary arteryen_US
dc.subjectpulmonary hypertensionen_US
dc.titleHoarseness as a Predictor for Pulmonary Arterial Aneurysm and Extrinsic Left Main Coronary Artery Compression in Patients with Severe Pulmonary Hypertensionen_US
dc.typeArticleen_US

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