Impact of cardiac factors on central airway anatomical parameters in patients undergoing lung mass surgery

Background: The correlation between central airway anatomical parameters and demographic factors, such as sex, age, weight, height, body mass index (BMI), and cardiac factors, remains unclear. This study examined the correlation between these factors and central airway anatomical parameters in adult patients.

Methods: All consecutive patients who underwent lung mass surgery at our hospital between December 2020 and December 2023 were included in this study. DeepInsight software was used to analyze high-resolution chest computed tomography (HRCT) images and to measure various central airway anatomical parameters, including tracheal diameter (TD), tracheal length (TL), left main bronchus diameter (LBD), left main bronchus length (LBL), right main bronchus diameter (RBD), right main bronchus length (RBL), and subcarinal angle (SCA). A multivariate linear regression analysis was performed to evaluate the independent effects of sex, age, weight, height, BMI, left atrial diameter, and diastolic left ventricular internal diameter (LVIDd) on these anatomical parameters.

Results: Among the 391 patients included in this study, all were over 18 years old, with 192 male and 199 female. The multivariate linear regression analysis indicated that in male patients with lung masses, TD exhibited a negative correlation with age (β = - 0.032, P = 0.015) and a positive correlation with height (β = 0.099, P < 0.001). Furthermore, TL exhibited a positive correlation with height (β = 0.311, P = 0.004). LBL was substantially influenced by age (β = - 0.098, P = 0.011), height (β = 0.204, P = 0.003), and BMI (β = 0.311, P = 0.026). Conversely, RBD exhibited notable correlations with height (β = 0.062, P = 0.02), BMI (β = - 0.113, P = 0.039), and left atrial size (β = 0.111, P = 0.007). In female patients, TD and TL exhibited positive correlations with height (β = 0.065, P = 0.01; β = 0.337, P = 0.01, respectively). LBL was significantly correlated only with height (β = 0.171, P = 0.045), whereas LBD exhibited an inverse correlation with age (β = - 0.024, P = 0.014). In addition, changes in SCA were positively associated with left atrial size (β = 0.65, P = 0.042), indicating a potential anatomical correlation.

Conclusion: This study innovatively examined the impact of cardiac factors on central airway anatomical parameters in adult patients with lung masses. Notably, age, as an important factor in airway development, was found to have significant associations with tracheal characteristics along with height in males, while tracheal features exhibited a particularly strong relationship with height in females. Furthermore, the study identified associations between right bronchial diameter (RBD) in males and subcarinal angle (SCA) in females with left atrial size, although these findings require further validation in larger and more diverse populations.