title: Factors determining altered perfusion after acute pulmonary embolism assessed by quantified single-photon emission computed tomography-perfusion scan.
abstract: OBJECTIVE
  The aim of the study was to analyze the evolution of perfusion (Q)-defects in patients treated for acute pulmonary embolism (PE), correlation with baseline parameters and evaluation of recurrence risk.
  
  
  METHODS
  This is a single-center prospective observational cohort study in symptomatic normotensive PE. Comparison of the ventilation/perfusion single-photon emission computed tomography (V/Q-SPECT) acquired at baseline with a quantified SPECT (Q-SPECT) repeated at 1 week and 6 months. The Q-defect extent (percentage of total lung volume affected) was measured semiquantitatively. Data collected at baseline were age, gender, body mass index (BMI), history of previous venous thromboembolism (HVTE), Charlson's Comorbidity Score (CcS), plasma troponin-T and D-dimer levels, PE Severity Index, and tricuspid regurgitation jet (TRJ) velocity.
  
  
  RESULTS
  Forty-six patients (22 men/24 women, mean age 61.7 years (± standard deviation 16.3)) completed the study. At 1 week, 13/46 (28.3 %) and at 6 months 22/46 (47.8%) patients had completely normalized Q-SPECT. Persistence of Q-defects was more frequent in female patients in univariate and multivariate analysis. We found no correlation between the persistence of Q-defects on Q-SPECT and HVTE, BMI, plasma troponin-T, and CcS. However, lower TRJ and younger age were statistically significantly linked to normalization of Q-scans after 6 months of treatment only in univariate analysis. There is no difference in the frequency of recurrent PE in relation to the persistence of Q-defects.
  
  
  CONCLUSIONS
  Acute PE patients of female, older age, and higher TRJ in univariate analysis and patients of female in multivariate analysis seem to have a higher risk of persistent Q-defects after 6 months treatment. The presence of residual Q-abnormalities at 6 months was not associated with an increased risk for recurrent PE.
authors.affiliation: Department of Medicine, Respiratory Division, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Meysman
authors.affiliation: Department of Nuclear Medicine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Everaert
authors.affiliation: Department of Medicine, Respiratory Division, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Vincken
keywords: Pulmonary embolism; recurrent pulmonary embolism; residual perfusion defects