Assessment of the severity of acute pulmonary embolism using CT pulmonary angiography parameters.
OBJECTIVE
To evaluate the association between computed tomography parameters and clinical signs in patients with acute pulmonary embolism.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic.
Vladimir
V
Kincl
Department of Imaging Methods and International Clinical Research Center, St. Anne's University Hospital in Brno, Brno.
Vera
V
Feitova
Department of Cardiovascular Diseases, International Clinical Research Center, St. Anne's University Hospital in Brno, Brno, Czech Republic.
Roman
R
Panovsky
International Clinical Research Center, St. Anne's University Hospital in Brno, Brno.
Radka
R
Stepanova
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D000072226:Computed Tomography Angiography; D003287:Contrast Media; D003422:Critical Care; D004452:Echocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006439:Hemodynamics / Q000502:physiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D020107:Troponin T / Q000378:metabolism; D055815:Young Adult
D015415:Biomarkers; D003287:Contrast Media; D005343:Fibrinolytic Agents; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
CT angiography; clinical signs; pulmonary embolism; risk assessment