Key result
PAAT and PAAT/RVET ratio accurately detect early pulmonary hypertension in infants of diabetic mothers.
Why the study?
Infants of diabetic mothers are at increased risk of pulmonary hypertension, and the diagnostic accuracy of emerging indices like PAAT and PAAT/RVET ratio compared to conventional echocardiographic parameters required evaluation.
Do PAAT and PAAT/RVET ratio accurately detect pulmonary hypertension in infants of diabetic mothers compared to conventional echocardiographic parameters?
Cross-Sectional (n=100)
No
Do PAAT and PAAT/RVET ratio accurately detect pulmonary hypertension in infants of diabetic mothers compared to conventional echocardiographic parameters?
Effect estimate: AUC 0.968 for PAAT/RVET; AUC 0.957 for PAAT
p-value: p=<0.001
PAAT and the PAAT/RVET ratio are highly accurate, non-invasive echocardiographic markers for early detection of pulmonary hypertension in infants of diabetic mothers, outperforming traditional Doppler-based measures.
May support noninvasive PH detection in IDMs; leaves open prospective validation before clinical adoption.
Background: Infants of diabetic mothers (IDMs) are at increased risk of developing pulmonary hypertension (PH), a condition associated with significant neonatal morbidity. Echocardiography is a key non-invasive tool for early PH detection. Recently, pulmonary artery acceleration time (PAAT) and the PAAT to right ventricular ejection time (PAAT/RVET) ratio have emerged as promising indicators of pulmonary vascular resistance. Aim: To evaluate the diagnostic accuracy of PAAT and PAAT/RVET ratio in detecting PH in IDMs and compare them with conventional echocardiographic parameters. Patients and Methods: A cross-sectional study was conducted on 50 IDMs admitted to the NICU at Minia University Hospital and 50 age- and sex-matched healthy neonates. All underwent transthoracic echocardiography to assess PAAT, PAAT/RVET ratio, tricuspid regurgitation peak gradient (TRPG), and systolic pulmonary artery pressure (SPAP). Results: IDMs with PH had significantly lower PAAT and PAAT/RVET ratios, and higher SPAP compared to controls (p < 0.001). PAAT showed excellent diagnostic performance (AUC 0.957) with a cut-off <74 ms (92% sensitivity, 96% specificity). The PAAT/RVET ratio had even higher accuracy (AUC 0.968) at a cut-off ≤0.36 (94% sensitivity, 96% specificity). SPAP showed lower diagnostic value (AUC 0.838). Conclusions: PAAT and PAAT/RVET ratio are effective, non-invasive echocardiographic markers for early PH detection in IDMs, with superior diagnostic performance compared to traditional Doppler-based measures methods
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Ali et al. (2026) conducted a cross-sectional in Pulmonary hypertension in infants of diabetic mothers (n=100). Pulmonary artery acceleration time (PAAT) and PAAT/RVET ratio vs. Conventional echocardiographic parameters (SPAP) and healthy controls was evaluated on Diagnostic accuracy of PAAT and PAAT/RVET ratio in detecting pulmonary hypertension (AUC 0.968 for PAAT/RVET; AUC 0.957 for PAAT, p=<0.001). The PAAT/RVET ratio and PAAT demonstrated excellent diagnostic accuracy for early detection of pulmonary hypertension in infants of diabetic mothers (AUC 0.968 and 0.957, respectively).
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