Yıl: 2014 Cilt: 15 Sayı: 3 Sayfa Aralığı: 117 - 121 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism

Öz:
OBJECTIVES: In this study, we aimed to localize thrombus and to evaluate the relationship between the site of thrombus and right ventricular dysfunction (RVD) in patients with pulmonary embolism (PE) diagnosed with computed tomography pulmonary angiography (CTPA). MATERIAL AND METHODS: CTPA and echocardiography (ECHO) findings of 59 patients (35 male, 24 female) with PE diagnosed on CTPA were analysed retrospectively. The site of thrombus on CTPA was documented. Patients were divided into 2 groups according to ECHO findings as patients without RVD (group 1) and with RVD (group 2). RESULTS: The most frequent sites of thrombus formation were the right main pulmonary artery (33.8%) and right lower lobar artery (30.5%). It was observed that thrombus formation was significantly higher in the right system than that of the left (63.8% and 36.2%, respectively; p<0.01). ECHO findings revealed that 16 of the 59 patients had RVD. The number of patients who had thrombus in the right main pulmonary artery was significantly higher in group 2 (p<0.001). Pulmonary trunk diameter measured by CT was significantly lower in group 1 (28 mm±3.61) in comparison to that in group 2 (37 mm±5.88) (p<0.01). Systolic pulmonary artery pressure was significantly positively correlated with pulmonary trunk and right ventricular diameter (p<0.001). Sensitivity, specificity and positive predictive value of CTPA in detecting RVD were 87.5% (14/16), 95.3% (41/43) and 87.5% (14/16), respectively. CONCLUSION: It was observed that the probability of RVD was higher in patients with thrombus in right main pulmonary artery. There was a strong relationship between the pulmonary trunk and right ventricular diameter measured by CT and RVD observed on ECHO. It was suggested that CTPA is a reliable imaging method for detecting RVD in patients with PE.
Anahtar Kelime:

Konular: Solunum Sistemi Kulak, Burun, Boğaz
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Alikhan R, Peters F, Wilmott R, Cohen AT. Fatal pulmonary embolism in hospitalised patients: a necropsy review. J Clin Pathol 2004;57:1254-7. [Crossref]
  • Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem. Best Pract Res Clin Haematol 2012;25:235-42. [Crossref]
  • Heit JA, O'Fallon WM, Petterson TM, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a popu- lation-based study. Arch Intern Med 2002;162:1245-8. [Crossref]
  • Isabelle TL, Marquette CH, Perez T, et al. Pulmonary Embolism in Patients with Unexplained Exacerbation of Chronic Obstructive Pulmonary Disease: Prevalence and Risk Factors. Ann Intern Med 2006;144:390-6. [Crossref]
  • Patel S, Kazerooni EA, Cascade PN. Pulmonary embolism: Optimization of small pulmonary artery visualization at multi- detector row CT. Radiology 2003;227:455-60. [Crossref]
  • Remy-Jardin M, Pistolesi M, Goodman LR, et al. Management of suspected acute pulmonary embolism in the era of CT angi- ography: a statement from the Fleischner Society. Radiology 2007;245:315-29. [Crossref]
  • Henzler T, Barraza JM Jr, Nance JW Jr, et al. CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr 2011;5:3-11. [Crossref]
  • Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial asses- sing right ventricular function and pulmonary perfusion. Lancet 1993;341:507-11. [Crossref]
  • Ribeiro A, Lindmarker P, Johnsson H, et al. Pulmonary embo- lism: one-year follow-up with echocardiography Doppler and five-year survival analysis. Circulation 1999;99:1325-30. [Crossref]
  • Goldhaber SZ. Echocardiography in the management of pulmo- nary embolism. Ann Intern Med 2002;136:691-700. [Crossref]
  • Henzler T, Barraza JM Jr, Nance JW Jr, et al. CT imaging of acute pulmonary embolism. J Cardiovasc Comput Tomogr 2011;5:3-11. [Crossref]
  • Golpe R, Pérez-de-Llano LA, Castro-Anon O, et al. Right ventric- le dysfunction and pulmonary hypertension in hemodynamically stable pulmonary embolism. Respir Med 2010;104:1370-6. [Crossref]
  • de Monye W, van Strijen MJ, Huisman MV, et al. Suspected pulmonary embolism: Prevalence and anatomic distribution in 487 consecutive patients. Advances in New Technologies Evaluating the Localisation Of Pulmonary Embolism (ANTELOPE) Group. Radiology 2000;215:184-8. [Crossref]
  • Oser RF, Zuckerman DA, Gutierrez FR, Brink JA. Anatomic distribution of pulmonary emboli at pulmonary angiography: Implications for cross-sectional imaging. Radiology 1996;199:31-5.
  • Duru S, Ergün R, Dilli A, et al. Clinical, laboratory and compu- ted tomography pulmonary angiography results in pulmonary embolism: retrospective evaluation of 205 patients. Anadolu Kardiyol Derg 2012;12:142-9.
  • Şimşek A, Türkkan Ö, Melek K, Eyüboğlu FÖ. Assessment of Patients with Pulmonary Thromboembolism (PTE) Diagnosed in Our Clinic: 5 Years Experience. Turkish Thoracic Journal 2010;11:149-54. [Crossref]
  • Grifoni S, Olivotto I, Cecchni P, et al. Short-term outcome of patients with acute pulmonary embolism, normal blood pressu- re, and echocardiographic right ventricular dysfunction. Circulation 2000;101:2817-22. [Crossref]
  • Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, et al. Echocardiography Doppler in pulmonary embolism: right vent- ricular dysfunction as a predictor of mortality. Am Heart J 1997;134:479-87. [Crossref]
  • Lim KE, Chan CY, Chu PH, et al. Right ventricular dysfunction secondary to acute massive pulmonary embolism detected by helical computed tomography pulmonary angiography. Clin Imaging 2005;29:16-21. [Crossref]
  • Contractor S, Maldjian PD, Sharma VK, Gor DV. Role of Helical CT in detecting right ventricular dysfunction secondary to acute pulmonary embolism. J Comput Assist Tomogr 2006;4:587-91.
  • Ozsu S, Karaman K, Mentese A, et al. Combined risk stratifica- tion with computerized tomography / echocardiography and biomarkers in patients with normotensive pulmonary embo- lism. Thromb Res 2010;126:486-92. [Crossref]
APA IN E, TURGUT T, KALKAN M, KARADAĞ OTLU M, DAĞLI M (2014). The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. , 117 - 121.
Chicago IN ERDAL,TURGUT Teyfik,KALKAN Mehmet,KARADAĞ OTLU Müge,DAĞLI Mustafa Necati The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. (2014): 117 - 121.
MLA IN ERDAL,TURGUT Teyfik,KALKAN Mehmet,KARADAĞ OTLU Müge,DAĞLI Mustafa Necati The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. , 2014, ss.117 - 121.
AMA IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. . 2014; 117 - 121.
Vancouver IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. . 2014; 117 - 121.
IEEE IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M "The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism." , ss.117 - 121, 2014.
ISNAD IN, ERDAL vd. "The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism". (2014), 117-121.
APA IN E, TURGUT T, KALKAN M, KARADAĞ OTLU M, DAĞLI M (2014). The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. Türk Toraks Dergisi, 15(3), 117 - 121.
Chicago IN ERDAL,TURGUT Teyfik,KALKAN Mehmet,KARADAĞ OTLU Müge,DAĞLI Mustafa Necati The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. Türk Toraks Dergisi 15, no.3 (2014): 117 - 121.
MLA IN ERDAL,TURGUT Teyfik,KALKAN Mehmet,KARADAĞ OTLU Müge,DAĞLI Mustafa Necati The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. Türk Toraks Dergisi, vol.15, no.3, 2014, ss.117 - 121.
AMA IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. Türk Toraks Dergisi. 2014; 15(3): 117 - 121.
Vancouver IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism. Türk Toraks Dergisi. 2014; 15(3): 117 - 121.
IEEE IN E,TURGUT T,KALKAN M,KARADAĞ OTLU M,DAĞLI M "The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism." Türk Toraks Dergisi, 15, ss.117 - 121, 2014.
ISNAD IN, ERDAL vd. "The Relationship between Computed Tomography Pulmonary Angiography Findings and Right Ventricular Dysfunction in Patients with Pulmonary Embolism". Türk Toraks Dergisi 15/3 (2014), 117-121.