title: Study of clinical, radiological and echocardiographic features and correlation of Qanadli CT index with RV dysfunction and outcomes in pulmonary embolism.
abstract: BACKGROUND
  There are no Indian studies correlating the CT pulmonary embolism index (Qanadli) with right ventricular function and outcome. In the present study we aimed to study the clinical manifestations of patients presenting with acute pulmonary thromboembolism and correlate the radiographic features with echocardiographic features and outcome.
  
  
  METHODS
  Thirty five patients presenting with symptomatic acute pulmonary thromboembolism in between 2011 and 2013 were studied for clinical, radiological and echocardiographic features and outcome (in-hospital & 1 month follow up).
  
  
  RESULTS
  The mean duration of presentation after onset of symptoms was 5.7 ± 3.7 days. Right ventricular dysfunction was observed in 11 (31.4%) patients. Out of 35 patients in whom CT pulmonary angiogram performed, 14 patients had Qanadli PE index >60% of whom 11 (78.6%) patients had right ventricular dysfunction. None had right ventricular dysfunction when PE index was <60% (p < 0.001). There was significant correlation between pulmonary vascular obstruction index and right ventricular dysfunction (p < 0.0001). Nine (25.7%) patients were thrombolysed with Streptokinase. Total mortality including in-hospital and 1 month follow up was 11.4% (4 patients). The mortality in patients with PE index >60% was 21.4% and was nil with <60% (p = 0.02). The mortality in patients with right ventricular dysfunction was 27.2% and was nil without right ventricular dysfunction (p = 0.0075).
  
  
  CONCLUSIONS
  A PE index which was shown to be a strong independent predictor of right ventricular dysfunction in PE, correlating linearly with different variables associated with higher morbidity and mortality, enabling accurate risk stratification and selection of patients for more aggressive treatment.
authors: Assistant Professor, Department of Cardiology, SVIMS, Tirupati, A.P., India.
authors: B S
authors: BS
authors: Praveen Kumar
authors: Professor and Head, Department of Cardiology, Sri Venkateswara Institute of Medical Sciences & University (SVIMS), Tirupati 517507, A.P., India. Electronic address: cardiologysvims@gmail.com.
authors: D
authors: D
authors: Rajasekhar
authors: Professor, Department of Cardiology, SVIMS, Tirupati, A.P., India.
authors: V
authors: V
authors: Vanajakshamma
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Acute pulmonary embolism; Qanadli PE index; RV dysfunction
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