Buscar en
Radiología (English Edition)
Toda la web
Inicio Radiología (English Edition) Pulmonary artery obstruction index, pulmonary artery diameter and right ventricl...
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
0
Original article
DOI: 10.1016/j.rxeng.2021.04.001
Available online 19 May 2021
Pulmonary artery obstruction index, pulmonary artery diameter and right ventricle strain as prognostic CT findings in patient with acute pulmonary embolism
Índice de obstrucción de la arteria pulmonar, diámetro de la arteria pulmonar y strain del ventrículo derecho como hallazgos pronósticos de la tomografía computarizada en el paciente con embolia pulmonar aguda
Visits
...
S. Hajiahmadia, F. Tabeshb, A. Shayganfara, F. Shiranic,
Corresponding author
fshirani71@yahoo.com

Corresponding author.
, S. Ebrahimiand
a Assistant Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
b Assistant Professor, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
c Resident, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
d Postdoctoral researcher, Massachusetts General Hospital, United States of America
Received 25 August 2020. Accepted 01 February 2021
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (9)
Show moreShow less
Tables (4)
Table 1. Predictive value of the cutoff point of 18 for PAOI in detecting patients susceptible to long-term pulmonary embolism complications.
Table 2. The mean±SD of PAOI in different follow-up echocardiographic indices.
Table 3. Sensitivity, specificity and predictive value of RV strain and PAD in detecting patients susceptible to long-term pulmonary embolism complications.
Table 4. OR for CTA indices in prediction of right heart echocardiographic abnormalities development in echocardiography.
Show moreShow less
Abstract
Objective

This study was designed to determine predictors of pulmonary hypertension and signs of right heart dysfunction caused by pulmonary embolism (PE) that may lead to early detection of high-risk patients. So the predictive value of pulmonary artery obstruction index (PAOI), measured by pulmonary CT angiography (PCTA) in the acute setting, in predicting the patients susceptible to PE cardiac complications was evaluated. Also two other PCTA indices, pulmonary artery diameter (PAD), and right ventricle (RV) strain, in these patients were investigated and their predictive value for cardiac complications on follow up echocardiography were demonstrated.

Materials and methods

In the study 120 patients with a definite diagnosis of PE were included. The PAOI, PAD and RV strain were measured using PCTA at the time of the initial diagnosis. Transthoracic echocardiography was done 6 months after the diagnosis of PE and RV echocardiographic indices were measured. Pearson correlation was used to investigate correlation between PAOI, PAD, RV strain and signs of right heart dysfunction.

Results

PAOI was strongly correlated with systolic pulmonary artery pressure (SPAP) (r=0.83), RV systolic pressure (r=0.78) and RV wall thickness (r=0.61) in long-term follow up echocardiography. A higher rate of RV dysfunction and RV dilation was detected among the patients with higher PAOI (P<0.001). PAOI18 was strongly predictive for development of RV dysfunction. Also developments of pulmonary hypertension, RV systolic hypertension, RV dilation, RV dysfunction, and RV hypertrophy were significantly more common among patients with higher PAD and RV strain (P<0.001).

Conclusions

PAOI, PAD and RV strain are sensitive and specific PCTA indices that can predict the development of long-term complications such as pulmonary hypertension and right heart dysfunction, at the time of initial PE diagnosis.

Keywords:
Pulmonary embolism
Computed tomography angiography
Echocardiography
Pulmonary hypertension
Resumen
Objetivo

Este estudio fue diseñado para determinar los predictores de la hipertensión pulmonar y los signos de disfunción cardíaca derecha causados por la embolia pulmonar (EP) que pueden conducir a la detección temprana de los pacientes de alto riesgo. Por lo tanto, se evaluó el valor predictivo del índice de obstrucción de la arteria pulmonar (IOAP), medido mediante angiografía pulmonar por TC (APTC) en el contexto agudo, para predecir los pacientes susceptibles de sufrir complicaciones cardíacas por EP. También se investigaron otros dos índices de APTC, el diámetro de la arteria pulmonar (DAP) y el strain del ventrículo derecho (VD), en estos pacientes y se demostró su valor predictivo de las complicaciones cardíacas en la ecocardiografía de seguimiento.

Materiales y métodos

En el estudio fueron incluidos 120 pacientes con diagnóstico definitivo de EP. El IOAP, el DAP y el strain del VD se midieron mediante APTC en el momento del diagnóstico inicial. Se realizó una ecocardiografía transtorácica 6 meses después del diagnóstico de EP y se midieron los índices ecocardiográficos del VD. Se utilizó la correlación de Pearson para investigar la correlación entre IOAP, DAP, strain del VD y los signos de disfunción del hemicardio derecho.

Resultados

El IOAP estaba fuertemente correlacionado con la presión arterial pulmonar sistólica (PAPS) (r=0,83), la presión sistólica del VD (r=0,78) y el grosor de la pared del VD (r=0,61) en la ecocardiografía de seguimiento a largo plazo. Se detectó una mayor tasa de disfunción del VD y de dilatación del VD entre los pacientes con mayor IOAP (p<0,001). Un IOAP18 fue claramente predictivo del desarrollo de la disfunción del VD. También la evolución de la hipertensión pulmonar, la hipertensión sistólica del VD, la dilatación del VD, la disfunción del VD y la hipertrofia del VD fueron significativamente más frecuentes entre los pacientes con mayor DAP y strain del VD (p<0,001).

Conclusiones

El IOAP, el DAP y el strain del VD son índices de APTC sensibles y específicos que pueden predecir el desarrollo de complicaciones a largo plazo, como la hipertensión pulmonar y la disfunción cardíaca derecha, en el momento del diagnóstico inicial de la EP.

Palabras clave:
Embolia pulmonar
Angiografía por tomografía computarizada
Ecocardiografía
Hipertensión pulmonar

Article

These are the options to access the full texts of the publication Radiología (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos