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).
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?
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.
Effect estimate: AUC 0.968 for PAAT/RVET; AUC 0.957 for PAAT
p-value: p=<0.001
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
Ali et al. (Thu,) 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).