scholarly journals Pulmonary hypertension as a risk assessment factor for unfavorable outcome in patients with COVID-19

2020 ◽  
Vol 25 (12) ◽  
pp. 4136
Author(s):  
E. Z. Golukhova ◽  
Inessa Viktorovna Slivneva ◽  
M. M. Rybka ◽  
M. L. Mamalyga ◽  
M. N. Alekhin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Artery ◽  
Mortality Risk ◽  
Systolic Pressure ◽  
Unfavorable Outcome ◽  
Diagnostic Methods ◽  
Pulmonary Hemodynamics ◽  
Organ System Failure ◽  
Group 3 ◽  
Group 1

Aim. To determine the predictive role of estimated pulmonary artery systolic pressure (ePASP) in COVID-19 patients.Material and methods. A retrospective study of inpatients with documented COVID-19 infection was carried out. Maximal follow-up period was 63 days. The study included 108 patients (men, 62; women, 46; mean age, 62,9±15,5 years). At admission, mean NEWS score was 6,0, blood oxygen saturation — 92%. Echocardiography was performed according to standard protocol using Vivid E9 ultrasound system (GE Healthcare). Quantitative measurements were performed according to the current ASE and EACVI guidelines. Statistical analysis was performed using the IBM SPSS Statistics v.26 software (developed by IBM Corporation).Results. Using the CHAID technique, a classification tree was developed and the strongest predictor of an unfavorable outcome was determined (ePASP). Threshold ePASP values, associated with an increased mortality risk were established (42 mm Hg and 50 mm Hg). Three groups of patients were selected based on the main predictor (<41,0 mm Hg, 42-49 mm Hg and >50 mm Hg). The increased mortality risk was noted in groups 2 and 3 compared to group 1 of patients and amounted to 31,8% and 70% versus 3,9%, respectively. There was also a correlation between the severity of CT lung parenchymal lesions according to computed tomography and the study groups of patients (36% [30-49%] — group 1, 50% [36-76%] — group 2, and 84% [56-92%] — group 3, p=0,001). In groups 2 and 3, the following complications were significantly more frequent: acute respiratory distress syndrome, acute heart failure, multiple organ system failure, venous thrombosis, disseminated intravascular coagulation. In group 3, acute renal failure and systemic inflammatory response syndrome developed significantly more often than in group 1.Conclusion. A comprehensive echocardiography has proven its availability and safety in assessing the condition of COVID-19 patients, allowing to obtain relevant information on pulmonary hemodynamics. Transthoracic echocardiography reduced the risk of complications from invasive diagnostic methods and allowed to abandon the use of the Swan-Ganz pulmonary artery catheter in the studied group of patients. As a result, a relationship was noted between the increase of ePASP and the severity of clinical performance and lung tissue damage according to computed tomography, changes in laboratory blood tests, the severity of the comorbid profile, an increase in respiratory support need.

scholarly journals A tissue-engineered urinary conduit in a porcine urinary diversion model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arkadiusz Jundziłł ◽  
Piotr Kwieciński ◽  
Daria Balcerczyk ◽  
Tomasz Kloskowski ◽  
Dariusz Grzanka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Diversion ◽  
Porcine Model ◽  
Histological Evaluation ◽  
Metabolic Complications ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

AbstractThe use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant’s remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.

scholarly journals Post-COVID-19 syndrome: morpho-functional abnormalities of the heart and arrhythmias

2021 ◽  
Vol 26 (7) ◽  
pp. 4485
Author(s):  
M. V. Chistyakova ◽  
D. N. Zaitsev ◽  
A. V. Govorin ◽  
N. A. Medvedeva ◽  
A. A. Kurokhtina
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Cardiac Arrhythmias ◽  
Myocardial Strain ◽  
Left Ventricular ◽  
Upper Respiratory Tract ◽  
Regional Strain ◽  
Group 3 ◽  
The Right ◽  
Group 1

Aim. To study the myocardial morpho-functional abnormalities, the incidence and nature of cardiac arrhythmias in patients 3 months after the coronavirus disease 2019 (COVID-19).Material and methods. The study included 77 patients (mean age, 35,9 years) treated for coronavirus infection, which underwent echocardiography and 24-hour Holter monitoring 3 months after COVID-19. The patients were divided into 3 groups: group 1 — 31 patients with upper respiratory tract involvement; group 2 — 27 patients with bilateral pneumonia (CT grade 1, 2), 3 — 19 patients with severe pneumonia (CT grade 3, 4). Statistical processing was carried out using Statistica 10.0.Results. According to echocardiography, the peak tricuspid late diastolic velocity and isovolumetric contraction time in all groups increased (P<0,001). The tricuspid and mitral Em/Am ratio decreased depending on the disease severity. In group 3, the right ventricular and atrial size increased (P<0,001). The pulmonary artery systolic pressure, left atrial volume in patients of the 2nd and 3rd groups was higher than in the control one (P<0,001). In group 1 and 2 patients, the regional strain in basal and basal/middle segments decreased, respectively, while, in group 3, not only regional but also global left ventricular (LV) strain decreased (P<0,001). In all groups, cardiac arrhythmias and pericardial effusion were found. The relationship was established between coronavirus activity and the structural and functional myocardial parameters (P<0,001).Conclusion. Cardiovascular injury 3 months after COVID-19 was found in 71%, 93%, and 95% of patients with mild, moderate and severe course. In mild course patients, a decrease in regional myocardial strain in LV basal segments, signs of past pericarditis, and various cardiac arrhythmias were noted. In patients of moderate severity, these changes were more pronounced and were accompanied by an additional decrease in regional strain in LV middle segments, impaired right ventricular diastole and increased pulmonary artery pressure. In severe patients, in addition to the above changes, dilatation of the right heart and inferior vena cava was recorded, as well as LV diastolic and global systolic function decreased.

scholarly journals A detailed analysis of patients included in the Summary Hospital-level Mortality Indicator (SHMI) for myocardial infarction (MI)—all is not what it seems?

2020 ◽  
Vol 9 (2) ◽  
pp. e000836
Author(s):  
Vinoda Sharma ◽  
Saqib Chowdhary ◽  
Fairoz Abdul ◽  
Vladimír Džavík ◽  
Chetan Varma
Keyword(s):  
Myocardial Infarction ◽  
Mortality Risk ◽  
Conservative Management ◽  
Hospital Level ◽  
Expected Number ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundThe Summary Hospital-level Mortality Indicator (SHMI) for Myocardial Infarction (MI) is the ratio of the observed to the expected number of deaths due to MI. We aimed to assess (1) the accuracy of MI as a diagnosis in the SHMI for MI and (2) the healthcare received by patients with type 1 MI included in the SHMI for MI.MethodsRetrospective review of patients included in SHMI for MI from April 2017 to March 2018. The diagnosis of MI was divided into type 1, type 2 and non-MI. For patients with type 1 MI who underwent intervention, we applied the prognostic Toronto Risk Score (TRS) and classified into group 0: score <13 (mortality risk 0%–4%, lowest risk), group 1: score 13–16 (mortality risk 6%–19.6%), group 2: score 17–19 (mortality risk 27.4%–47.6%) and group 3: score ≥20 (mortality risk 58%–92%). For patients with type 1 MI who underwent conservative management, we reviewed appropriateness of conservative management.ResultsSHMI for MI was 96 (41/42.83) falling to 65.4 with the inclusion of only type 1 MI (28 patients, 28/42.83). About 41.5% (n=17) underwent intervention of whom three were in the lowest risk TRS (group 0) and all received appropriate healthcare. Conservative management was appropriate for the 26.8% (n=11) treated medically, the most common reason was severe cognitive dysfunction.ConclusionsWe have demonstrated that SHMI for MI can be inaccurate due to the inclusion of type 2 MI or non-MI. Grouping patients into intervention versus conservative management helps in assessment of healthcare.

Carbonic Anhydrase Inhibition Improves Pulmonary Artery Reactivity and Nitric Oxide-Mediated Relaxation in Sugen-Hypoxia Model of Pulmonary Hypertension

2021 ◽  
Author(s):  
Helen Christou ◽  
Zoe Michael ◽  
Fotios Spyropoulos ◽  
Yunfei Chen ◽  
Dan Rong ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Carbonic Anhydrase ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Vascular Function ◽  
Systolic Pressure ◽  
Mesenteric Arteries ◽  
Pulmonary Hemodynamics ◽  
Carbonic Anhydrase Inhibition

Pulmonary hypertension (PH) is a serious disease with pulmonary arterial fibrotic remodeling and limited responsiveness to vasodilators. Our data suggest that mild acidosis induced by carbonic anhydrase inhibition could ameliorate PH, but the vascular mechanisms are unclear. We tested the hypothesis that carbonic anhydrase inhibition ameliorates PH by improving pulmonary vascular reactivity and relaxation mechanisms. Male Sprague-Dawley rats were either control normoxic (Nx), or injected with Sugen5416 (20mg/kg, sc) and subjected to hypoxia (9%O2) (Su+Hx), or Su+Hx treated with acetazolamide (ACTZ, 100mg/kg/day, in drinking water). After measuring the hemodynamics, right ventricular hypertrophy was assessed by Fulton's Index; vascular function was measured in pulmonary artery, aorta and mesenteric arteries; and pulmonary arteriolar remodeling was assessed in lung sections. Right ventricular systolic pressure and Fulton's Index were increased in Su+Hx and reduced in Su+Hx+ACTZ rats. Pulmonary artery contraction to KCl and phenylephrine were reduced in Su+Hx and improved in Su+Hx+ACTZ. Acetylcholine (ACh)-induced relaxation and nitrate/nitrite production were reduced in pulmonary artery of Su+Hx and improved in Su+Hx+ACTZ. ACh relaxation was blocked by nitric oxide (NO) synthase and guanylate cyclase inhibitors, supporting a role of NO-cGMP. Sodium nitroprusside (SNP)-induced relaxation was reduced in pulmonary artery of Su+Hx, and ACTZ enhanced relaxation to SNP. Contraction/relaxation were not different in aorta or mesenteric arteries of all groups. Pulmonary arterioles showed wall thickening in Su+Hx that was ameliorated in Su+Hx+ACTZ. Thus, amelioration of pulmonary hemodynamics during carbonic anhydrase inhibition involves improved pulmonary artery reactivity and NO-mediated relaxation, and may enhance responsiveness to vasodilator therapies in PH.

Multifactorial analysis of differential diagnostic parameters in patients with moderate bronchial asthma with pulmogenic arterial hypertension and essential arterial hypertension

2020 ◽  
Vol 21 (4) ◽  
pp. 135-139
Author(s):  
O. V. Shevchenko ◽  
◽  
V. F. Ushakov ◽  
E. V. Sadrieva ◽  
T. V. Zuevskaya ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Arterial Hypertension ◽  
Bronchial Asthma ◽  
Heart Function ◽  
Systolic Pressure ◽  
Cold Test ◽  
Gas Composition ◽  
Asthma Patients ◽  
Essential Arterial Hypertension ◽  
Group 1

Objective: to analyze differential diagnostic parameters in patients with moderate bronchial asthma with pulmogenic arterial hypertension with essential arterial hypertension. Material and Methods: 25 patients with moderate bronchial asthma with pulmogenic arterial hypertension (the 1st group) and 25 patients with moderate bronchial asthma with essential arterial hypertension (the 2nd group) were included in the study. Both groups of patients received step therapy (berodual + inhaled glucocorticosteroids). All patients underwent complex ultrasound examination of intracardiac hemodynamics, examination of blood flow in the right ventricle excretory tract. Systemic arterial pressure was measured according to N. S. Korotkov’s method. ECG was studied (24-hour monitoring). Cold test (at -20 °C-40 °C) was performed in both groups of patients, blood gas composition and pulmonary ventilation function indices were studied. Results: As a result of research established reliable differences in the spirographic indices, blood gas composition in patients with moderate bronchial asthma with pulmogenic arterial hypertension (the 1st group), and reliable differences in partial pressure of oxygen and carbon dioxide (p < 0,05). The 1st group of patients has also higher values of PaCO2 and reliably (p < 0,0,5) and lower values of PaO2, SaO2 in comparison with the comparison group of patients with bronchial asthma of average severity with essential arterial hypertension (the 2nd group). Our data have shown, that in the 1st and 2nd group patients systolic-diastolic cardiac function indexes reliably (p < 0,05; p < 0,001) differed from those ones in healthy subjects. At the same time systolic pressure in the pulmonary artery in the 1st group patients was higher than in the 2nd group patients, and left ventricular ejection fraction was significantly different from that in healthy people and was lower in the 1st group patients than in the 2nd group. We have revealed a reliable correlation between systolic blood pressure and Sа02 (r = 0,52, p < 0,05), studied after cold test, which confirmed the hypothesis of the formation of pulmogenic arterial hypertension against the background of hypoxia. More pronounced changes of FEV1, Sа02, systolic blood pressure in group 1 patients were to some extent due to significant cold hyperresponsiveness in this category of patients. Conclusions: the results of our studies have shown that the decrease of FEV1, FEV50, FEV75, PaO2, SaO2, increased systolic pressure in the pulmonary artery, signs of right heart hypertrophy, disturbances of systolic-diastolic heart function were more pronounced in moderate bronchial asthma patients with pulmogenic arterial hypertension than in moderate bronchial asthma patients with essential arterial hypertension. The proportion of patients (in %) with rhythm disturbances, especially sinus tachycardia, extrasystoles were detected significantly more frequently in group 1 patients than in group 2 patients, which was due to a more pronounced disturbance of systolic-diastolic heart function, higher systolic pressure in the pulmonary artery in persons with moderate bronchial asthma with pulmogenic arterial hypertension.

scholarly journals Pulmonary embolism attenuation is a potential imaging biomarker for pulmonary artery hemodynamic improvement after catheter-directed thrombolysis

2018 ◽  
Vol 23 (2) ◽  
pp. 134-138
Author(s):  
Edwin A Takahashi ◽  
Christopher J Reisenauer ◽  
Andrew H Stockland ◽  
Haraldur Bjarnason ◽  
Melissa J Neisen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Systolic Pressure ◽  
Imaging Biomarker ◽  
Spearman Correlation ◽  
Ventricular Systolic Pressure ◽  
Artery Pressure ◽  
Catheter Directed Thrombolysis

This study examined the potential correlation between pulmonary embolism (PE) attenuation on computed tomography pulmonary angiography (CTPA) and pulmonary artery hemodynamic response to catheter-directed thrombolysis (CDT) in 10 patients with submassive PE. Treatment parameters, PE attenuation, clot burden, computed tomography signs of right ventricle dysfunction and right ventricular systolic pressure at echocardiography were retrospectively analyzed to determine correlation with pulmonary artery pressure improvement using Spearman correlation. A single reader, blinded to the treatment results, measured PE attenuation of all patients. There was a significant positive correlation between PE attenuation and absolute pulmonary artery pressure improvement with a Spearman correlation of 0.741, p=0.014. When attenuation was greater than or equal to the median (44.5 HU, n=5), CDT was associated with significantly better pulmonary artery pressure improvement ( p=0.037). Clot attenuation at CTPA may be a potential imaging biomarker for predicting pulmonary artery pressure improvement after CDT.

scholarly journals Novel computed-tomography derived prognostic markers in patients undergoing TAVI with a self-expanding valve

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G Benetos ◽  
I Delakis ◽  
D Charitos ◽  
M Drakopoulou ◽  
S Soulaidopoulos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Computed Tomography ◽  
Aortic Valve ◽  
Pulmonary Artery ◽  
Systolic Pressure ◽  
Valvular Regurgitation ◽  
Heart Failure Hospitalization ◽  
Clinical Events ◽  
The Impact ◽  
Pulmonary Artery Diameter

Abstract Introduction Transcatheter aortic valve implantation is the treatment of choice in a consistently expanding group of patients with severe aortic valve stenosis. Tricuspid and mitral annular dilatation with consequent valvular regurgitation are associated with adverse outcome. Computed tomography angiography (CTA) is routinely performed for preprocedural evaluation of vascular access and prosthesis sizing. Purpose To evaluate the impact of mitral and tricuspid annular dimensions in preprocedural CTA on prognosis of patients undergoing TAVI with a self-expanding valve. Methods CTAs of consecutive patients undergoing TAVI in a single high-volume center between 2016 and 2019 were retrospectively evaluated. Maximal septolateral tricuspid annular diameters (TAD) and mitral annular diameters (MAD) were obtained and measured from properly angulated three dimensional CTA datasets. Moreover, maximal pulmonary artery diameter perpendicular to the long axis was measured in every patient. Patients were followed up by clinical visits or telephone contacts. As clinical events were defined all-cause mortality, stroke and heart failure hospitalization. Results In total 123 patients were included in the study. The mean follow-up duration was 875±383 days and 21 clinical events were recorded. There was a moderate but statistical significant correlation between TAD and both pulmonary artery diameter (r=0.39, p&lt;0.001) and pulmonary artery systolic pressure by echocardiography (r=0.23, p=0.015). In univariate logistic regression analysis pulmonary artery diameter and TAD were both associated with heart failure hospitalization (p=0.03 and 0.02 respectively). In addition, MAD was associated with total events (OR: 0.43, 95% CI 0.19–0.99, p=0.048). The relationship of MAD with events remained significant after adjustment for sex, age and tricuspid annular dimensions (OR: 0.28, 95% CI 0.1–0.79, p=0.02). Conclusions TAD and MAD were associated with heart failure rehospitalization and clinical events respectively in patients undergoing TAVI with a self-expanding valve. Further larger prospective studies are warranted to evaluate the prognostic value of these CTA markers. FUNDunding Acknowledgement Type of funding sources: None.

Effects of coronary ischemia on lung fluid balance in conscious sheep

1988 ◽  
Vol 65 (2) ◽  
pp. 617-624 ◽  
Author(s):  
T. Toyofuku ◽  
T. Kobayashi ◽  
K. Kubo ◽  
S. Koyama ◽  
S. Kusama
Keyword(s):  
Coronary Occlusion ◽  
Circumflex Artery ◽  
Pulmonary Hemodynamics ◽  
Left Circumflex Artery ◽  
Coronary Ischemia ◽  
Group 3 ◽  
Group 2 ◽  
Conscious Sheep ◽  
Lung Lymph ◽  
Group 1

It has been suggested that coronary ischemia increases extravascular lung water. To determine whether pulmonary microvascular permeability is increased by coronary ischemia, we measured pulmonary hemodynamics, lung lymph flow (QL), and lymph-to-plasma protein concentration ratio (L/P) in 12 sheep with chronic lung lymph fistulas. Studies were done in 3 groups: in group 1 (n = 7) a marginal branch of the left circumflex artery (Lcx) was occluded, in group 2 (n = 5) left atrial pressure (Pla) was mechanically raised by 10 mmHg, and in group 3 (n = 5) Lcx was occluded and Pla was raised by 10 mmHg. In group 1, coronary occlusion increased QL (4.6 +/- 0.4 to 8.3 +/- 2.6 ml/h) without changes in L/P. In group 2, elevated Pla increased QL (5.1 +/- 1.2 to 10.1 +/- 3.0 ml/h) with decreases in L/P (0.71 +/- 0.02 to 0.61 +/- 0.02). In group 3, coronary occlusion with elevated Pla caused a further increase in QL (5.0 +/- 1.5 to 16.9 +/- 4.6 ml/h) without significant decreases in L/P (0.71 +/- 0.01 to 0.65 +/- 0.06). Lung lymph concentrations of 6-keto-prostaglandin F1 alpha (a degradation product of prostacyclin) increased transiently after coronary occlusion. These results indicate that coronary occlusion can increase transcapillary protein transport in lungs of conscious sheep and simultaneously increase prostacyclin production in the lung.

scholarly journals The clinical implications of incidental coronary artery calcification in routine, non-triggered high-resolution thoracic computed tomography: a retrospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Saluja ◽  
J Sobolewska ◽  
K Khan ◽  
H Contractor ◽  
L.J Mitchell ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Risk Factor ◽  
Coronary Artery ◽  
High Resolution ◽  
Independent Risk Factor ◽  
Incidental Finding ◽  
Agatston Score ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Coronary artery calcium (CAC) is a marker of atherosclerosis and an independent risk factor for cardiac-related mortality. The measurement of this score has traditionally been based on using ECG triggered computed tomography (CT). However, CAC, identified on non-contrast high resolution chest computed tomography (HRCT), should be considered diagnostic for coronary artery disease (CAD). We aimed to evaluate the incidental prevalence and burden of CAC on non-gated HRCT thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease. We also assessed how often Radiologists reported CAC as an incidental finding on these scans. Methods Computerised Radiology Information Service (CRIS) was manually searched to determine all HRCT scans performed in our Trust from 01/05/2018 to 01/05/2019. The reports issued by Radiologists and images of selected studies were reviewed. Results 2185 HRCT scans were performed over this period. Patients were divided into three groups of age &lt;50 (Group 1); 50-&lt;60 (Group 2) and 60 (Group 3). 100 scans were randomly selected from each group using a random number generator to give a total of 300 patients. The mean ages of patients in Group 1, 2 and 3 were 48.3±2.3, 54.8±2.4 and 65±3.2 respectively. There was, approximately, the same number of males as females in each group. CAC was noted in 15% of scans in Group 1, 82% of scans in Group 2 and 94% scans in Group 3. CAC was only noted in 1/15 (6.7%) of scan reports in Group 1, 41/82 (50%) in Group 2 and 37/94 (39.4%) in Group 3. Among the 79 patients with radiologist-reported incidental CAC, statin and aspirin prescriptions increased by approximately 7 percentage points each. A diagnosis of CAD was eventually made in 9 (11.4%) patients through functional imaging or coronary angiogram. Two authors independently calculated the Agatston scores of HRCT scans whose reports did not comment on the degree of calcification. We excluded 15/112 (13.4%) scans as they were uninterpretable due to motion artefacts. Of the remaining 97 scans analysed 58/97 (59.8%) had severe CAC with an Agatston score of &gt;400 with the remaining showing moderate calcification (101–400). Cohen κ agreement between the two authors rating was 0.90 (95% confidence interval [CI] 0.87–0.96). Group 2 and 3 had significantly more patients with severe CAC then group 1 (p&lt;0.001). Left anterior descending artery was most commonly affected. Conclusion This study shows that CAC is under reported on non-gated HRCT scans which represents a missed opportunity to implement strategies for primary and secondary prevention. Given that respiratory disease is an independent risk factor for developing cardiac disease, it is incumbent upon the interpreting clinician to report all findings and ensure that critical findings are highlighted. The images of calcified coronary arteries may also potentially have a role in convincing people to make correct lifestyle choices. Funding Acknowledgement Type of funding source: None

scholarly journals Lateral cephalometric diagnosis of asymmetry in Angle Class II subdivision compared to Class I and II

2014 ◽  
Vol 19 (4) ◽  
pp. 80-88 ◽  
Author(s):  
Aparecida Fernanda Meloti ◽  
Renata de Cássia Gonçalves ◽  
Ertty Silva ◽  
Lídia Parsekian Martins ◽  
Ary dos Santos-Pinto
Keyword(s):  
Class Ii ◽  
Diagnostic Methods ◽  
Class I ◽  
Linear Measurements ◽  
Morphological Alterations ◽  
Mandibular Asymmetry ◽  
Study Results ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

INTRODUCTION: Lateral cephalometric radiographs are traditionally required for orthodontic treatment, yet rarely used to assess asymmetries. OBJECTIVE: The objective of the present study was to use lateral cephalometric radiographs to identify existing skeletal and dentoalveolar morphological alterations in Class II subdivision and to compare them with the existing morphology in Class I and II relationship. MATERIAL AND METHODS: Ninety initial lateral cephalometric radiographs of male and female Brazilian children aged between 12 to 15 years old were randomly and proportionally divided into three groups: Group 1 (Class I), Group 2 (Class II) and Group 3 (Class II subdivision). Analysis of lateral cephalometric radiographs included angular measurements, horizontal linear measurements and two indexes of asymmetry that were prepared for this study. RESULTS: In accordance with an Index of Dental Asymmetry (IDA), greater mandibular dental asymmetry was identified in Group 3. An Index of Mandibular Asymmetry (IMA) revealed less skeletal and dental mandibular asymmetry in Group 2, greater skeletal mandibular asymmetry in Group 1, and greater mandibular dental asymmetry in Group 3. CONCLUSION: Both IDA and IMA revealed greater mandibular dental asymmetry for Group 3 in comparison to Groups 1 and 2. These results are in accordance with those found by other diagnostic methods, showing that lateral cephalometric radiography is an acceptable method to identify existing skeletal and dentoalveolar morphological alterations in malocclusions.

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