Assessment of the severity of acute pulmonary embolism using CT pulmonary angiography parameters

• Published in: Biomedical papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia Vol. 159; no. 2; pp. 259 - 265
• Main Authors: Kincl, Vladimir, Feitova, Vera, Panovsky, Roman, Stepanova, Radka
• Format: Journal Article
• Language: English
• Published: Czech Republic Palacký University Olomouc, Faculty of Medicine and Dentistry 01.06.2015
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Biomarkers - metabolism; clinical signs; Computed Tomography Angiography; Contrast Media; Critical Care; ct angiography; Echocardiography; Female; Fibrinolytic Agents - therapeutic use; Hemodynamics - physiology; Hospitalization; Humans; Male; Middle Aged; Multimodal Imaging; Natriuretic Peptide, Brain - metabolism; Peptide Fragments - metabolism; pulmonary embolism; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - drug therapy; Pulmonary Embolism - physiopathology; Retrospective Studies; risk assessment; Troponin T - metabolism; Young Adult; CT angiography; risk assessment; pulmonary embolism; clinical signs
• ISSN: 1213-8118; 1804-7521
• DOI: 10.5507/bp.2013.082

To evaluate the association between computed tomography parameters and clinical signs in patients with acute pulmonary embolism. 109 patients retrospectivelly selected from hospital database with acute pulmonary embolism verified by CT pulmonary angiography. The following parameters were assessed: pulmonary artery diameter to aorta diameter ratio (PA/Ao), normalized pulmonary artery diameter (nPA), right ventricular to left ventricular diameter ratio from CT (RV CT/LV CT), normalized end-diastolic right ventricular diameter (nRVD echo) and right to left ventricular end diastolic diameter ratio (RV echo/LV echo) from echocardiography. Multivariate regression analysis showed a significant association between PA/Ao and thrombolysed (0.99) to non-thrombolysed (0.90) patients, OR=1.56 P=0.012, and also RV CT/LV CT and thrombolysed 1.5 to non-thrombolysed (0.94) patients OR=1.24 P=0.002. The significant difference was also found in intensive care unit hospitalization necessity (ICU-Y/N) and RV CT/LV CT ratio (ICU-Y 1.42, ICU-N 0.91) OR=1.26 P=0.003, and RV echo/LV echo (ICU-Y 0.82, ICU-N 0.65) OR=1.83 P=0.033. From the CT pulmonary angiography parameters, the RV CT/LV CT showed a significant association with both thrombolysis administration and ICU hospitalization. The PA/Ao had relation only to thrombolytic therapy as well as RV echo/LV echo only to ICU hospitalization.