{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T10:22:26Z","timestamp":1773829346460,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"published-print":{"date-parts":[[1994,3]]},"abstract":"<jats:p>The aim of this study was to re-examine the accuracy of the left atrial aortic root ratio (LA:Ao) as a marker of significant patent ductus arteriosus (PDA) in the preterm infant by comparison with direct Doppler echocardiographic assessment. Fifty six infants (&lt; 1500 g) had 463 serial echocardiograms. Firstly the LA:Ao was measured, then the duct was imaged and classified as wide open, restricting, or closed according to two dimensional and Doppler criteria. Probability analysis was performed to test the ability of the LA:Ao to discriminate between a wide open PDA and a restricting or closed duct. Mean LA:Ao was 1.17 and 1.21 when the duct was respectively closed or restricting compared with 1.61 when wide open. Using a LA:Ao of 1.5 as a cut off gives a sensitivity of 79% and specificity of 95% and increases the accuracy over the recommended levels of 1.3 and 1.4. With this cut off there were 20\/94 false negatives, these were associated with scans on day 1 and large interatrial shunts. The sensitivity of the LA:Ao increased to 88% if only scans performed after day 1 were analysed. For diagnosing a PDA after day 1, the positive likelihood ratio of an LA:Ao of 1.5 or more was 17.5, and the negative likelihood ratio of an LA:Ao &lt; 1.5 was 0.13. The LA:Ao is still a useful tool in the diagnosis of PDA. It is a simple method which needs less skill and resources than direct PDA imaging and is feasible on neonatal units without direct access to echocardiographic expertise. Its use on the first postnatal day is not recommended.<\/jats:p>","DOI":"10.1136\/fn.70.2.f112","type":"journal-article","created":{"date-parts":[[2008,10,31]],"date-time":"2008-10-31T17:55:51Z","timestamp":1225475751000},"page":"F112-F117","source":"Crossref","is-referenced-by-count":92,"title":["Re-evaluation of the left atrial to aortic root ratio as a marker of patent ductus arteriosus."],"prefix":"10.1136","volume":"70","author":[{"given":"P","family":"Iyer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Evans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S0022-3476(84)80499-0","article-title":"Patent ductus arteriosus in neonates with severe respiratory disease","volume":"104","author":"Dudell, G.G.; Gersony, W.M.","year":"1984","unstructured":"Dudell GG, Gersony WM. Patent ductus arteriosus in neonates with severe respiratory disease. J Pediatr 1984; 104: 915-20.","journal-title":"J Pediatr"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1111\/j.1651-2227.1987.tb10520.x","article-title":"Prediction of symptomatic patent ductus arteriosus in preterm infants using Doppler and M-mode echocardiography","volume":"76","author":"Mellander, M.; Larsson, L.E.; Ekstrom-Jodal, B.; Sabel, K.G.","year":"1987","unstructured":"Mellander M, Larsson LE, Ekstrom-Jodal B, Sabel KG. Prediction of symptomatic patent ductus arteriosus in preterm infants using Doppler and M-mode echocardiography. 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Eur J Pediatr 1988; 147: 279-82.","journal-title":"Eur J Pediatr"},{"key":"ref_4","first-page":"61","article-title":"A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosus","volume":"29","author":"Skelton, R.; Evans, N.J.; Smythe, J.","year":"1993","unstructured":"Skelton R, Evans NJ, Smythe J. A blinded comparison of clinical and echocardiographic evaluation of the preterm infant for patent ductus arteriosus. J Paediatr Child Health 1993; 29: A61.","journal-title":"J Paediatr Child Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1136\/adc.68.5_Spec_No.584","article-title":"Change in blood pressure after treatment of patent ductus arteriosus with indomethacin","volume":"68","author":"Evans, N.J.; Iyer, P.","year":"1993","unstructured":"Evans NJ, Iyer P. Change in blood pressure after treatment of patent ductus arteriosus with indomethacin. 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