Correlation of right ventricular dysfunction on acute pulmonary embolism with pulmonary artery computed tomography obstruction index ratio (PACTOIR) and comparison with echocardiography

Varol, Kenan; Gümüş, Cesur; Yücel, Hasan; Sezer, Ferhat; Şeker, Emrah; İnci, Mehmet Fatih; Yücel, Selma; Kaya, Hakan; Berk, Serdar; Yilmaz, Mehmet Birhan

doi:10.1007/s11604-015-0419-0

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…10 In the present study, the Mastora score differed significantly between the two patient groups, indicating that the scope and extent of mixed-type pulmonary embolism was significantly larger than those of distaltype pulmonary embolism, as seen in previous studies. 3,[22][23][24] Additionally, the clinical symptoms of mixed pulmonary embolism presented significantly earlier than those of peripheral pulmonary embolism (P < 0.05), indicating that mixed-type pulmonary embolism may cause more obvious clinical symptoms. 25 The distribution of pulmonary embolism is a continuous process.…”

Section: Discussionmentioning

confidence: 92%

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

et al. 2021

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Objective To explore the clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism (APE). Methods Sixty-four patients with APE were classified into mixed-type and distal-type pulmonary embolism groups. Their right ventricular systolic pressure (RVSP) and disease duration were recorded, and the diameter of their right ventricles was measured by ultrasound. The computed tomography angiographic clot load was determined as a Mastora score. Results Patients with distal-type pulmonary embolisms had significantly lower RVSPs (44.92 ± 17.04 vs 55.69 ± 17.66 mmHg), and significantly smaller right ventricular diameters (21.08 ± 3.06 vs 23.37 ± 3.48 mm) than those with mixed-type pulmonary embolisms. Additionally, disease duration was significantly longer in patients with distal-type pulmonary embolisms (14.33 ± 11.57 vs 8.10 ± 7.10 days), and they had significantly lower Mastora scores (20.91% ± 18.92% vs 43.96% ± 18.30%) than patients with mixed-type pulmonary embolisms. After treatment, RVSPs decreased significantly in patients with both distal-type and mixed-type pulmonary embolisms. Right ventricle diameters also decreased significantly in patients with mixed-type pulmonary embolisms after treatment. Conclusion Patients with mixed-type pulmonary embolisms are significantly more susceptible to pulmonary hypertension, enlarged right ventricular diameters, and shorter durations of disease than those with distal-type pulmonary embolisms. The distribution of pulmonary artery embolism in APE can provide a clinical reference.

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Section: Discussionmentioning

confidence: 92%

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

et al. 2021

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“…Although echocardiography is currently the modality of choice for RVD diagnosis, CPTA can replace echocardiography, because of its ability to detect PE and RVD simultaneously [8]. Studies show that among patients with PE, the PAOI ratio can recognize patients with or without RVD [6, 9].…”

Section: Introductionmentioning

confidence: 99%

The Association between the Pulmonary Arterial Obstruction Index and Atrial Size in Patients with Acute Pulmonary Embolism

Langroudi

Sheikh

Naderian

et al. 2019

Radiology Research and Practice

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Purpose. Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism. The aim of this study is to investigate the association between the pulmonary arterial obstruction index and atrial size in patients with acute pulmonary embolism. Basic Procedure. The study consisted of 86 patients with clinical symptoms of PE. Out of 86 individuals, 50 patients were diagnosed with PE and considered as the patient group. The others were considered as the control group. All patients were scanned by a multidetector CT scanner. Using the radiology workstation, an expert radiologist calculated the left atrium (LA) and right atrium (RA) areas from planimetric measurements obtained from free-hand delineation of the atrial boarders using an electronic pen. Quantitative volumetric measurements of LA and RA were obtained from original axial images. Main Findings. There were 25 males and 25 females with PE, who had a mean age of 58 years. There was not a significant difference in the positive history of diabetes mellitus, hypertension, asthma, chronic obstructive pulmonary diseases, ischemic heart disease, and smoking between patients and control group. There was a significant negative correlation between almost all LA measurements and the PAOI. RA area and volume had the highest area under the curves for recognizing larger clot burden. Principal Conclusions. A higher clot load is associated with a smaller LA size and increased RA/LA ratios, measured with CTPA. Atrial measurements are correlated with POAI, and they could be used as sensitive parameters in predicting heart failure in patients with PE.

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“…Acute pulmonary embolism (APE) is a life-threatening condition associated with in-hospital mortality rates ranging from 5 to 75%, depending on the hemodynamic status (1–5). As a consequence, a specific diagnosis is needed for early risk stratification (RS) and appropriate management (3, 4, 6).…”

Section: Introductionmentioning

confidence: 99%

Can a Trained Radiology Technician Do Arterial Obstruction Quantification in Patients With Acute Pulmonary Embolism?

Rotzinger

Breault

Knebel

et al. 2019

Front. Cardiovasc. Med.

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Objectives: To assess interobserver variability between a trained radiology technician (RT) and an experienced radiologist in arterial obstruction quantification using the Qanadli obstruction index (QOI), in patients diagnosed with acute pulmonary embolism (APE) at CT pulmonary angiography (CTPA). Materials and Methods: A RT and a radiologist independently reviewed CTPAs of 97 consecutive, prospectively enrolled patients with APE, and calculated the QOI. They classified patients into three risk categories: high for QOI ≥40%, intermediate for QOI 20–37.5%, low for QOI <20%. Interobserver variability was investigated for QOI as a continuous variable and as a categorical variable (high, intermediate, and low-risk groups). Results: Mean QOI (±SD) was 39.5 ± 24.3% and 38.6 ± 18.9% for the RT and the radiologist, respectively. The mean QOI was not statistically different between the RT and the radiologist ( p = 0.502), and the interobserver agreement was excellent (ICC = 0.905). The RT classified 54 patients (55.7%) as high, 17 (17.53%) as intermediate, and 26 (26.8%) as low risk. The radiologist classified 55 patients (56.7%) as high, 22 (22.7%) as intermediate, and 20 (20.6%) as low risk. The interrater agreement for risk stratification was excellent (weighted kappa = 0.844). Conclusion: Once the diagnosis of APE was established, an adequately trained RT achieved an accuracy comparable to that of an experienced radiologist regarding QOI calculation and risk assessment.

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Correlation of right ventricular dysfunction on acute pulmonary embolism with pulmonary artery computed tomography obstruction index ratio (PACTOIR) and comparison with echocardiography

Abstract: Our conclusions indicated that the PACTOIR rate in RVD diagnosis in patients with APE can recognize the patients with and without RVD.

Cited by 5 publications

References 22 publications

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

The Association between the Pulmonary Arterial Obstruction Index and Atrial Size in Patients with Acute Pulmonary Embolism

Can a Trained Radiology Technician Do Arterial Obstruction Quantification in Patients With Acute Pulmonary Embolism?

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