Correlation of Hematologic Indices with CT-pulmonary Arterial Obstruction Index in Patients with Acute Pulmonary Emboli

D-dimer might be correlated with prognosis in pulmonary embolism (PE). The predictive value of plasma D-dimer for disease severity and survival was investigated in the lowest and highest D-dimer quartile among 200 patients with PE. Patients with high D-dimers were significantly more often hypotensive ( P = .001), tachycardic ( P = .016), or hypoxemic ( P = .001). Pulmonary arterial obstruction index (PAOI) values were significantly higher in the high D-dimer quartile ( P < .001). Elevated troponin I (TNI) levels ( P < .001), simplified PE severity indices ≥1 ( P < .001), right-to-left ventricular (RV/LV) diameter ratios ≥1 ( P < .001), and thrombolysis ( P = .001) were more frequent in the high D-dimer quartile. D-dimer was associated with RV/LV ratios ≥1 ( P = .021), elevated PAOI ( P < .001) or TNI levels ( P < .001), hypotension ( P < .001), tachycardia ( P = .003), and hypoxemia ( P < .001), but not with long-term all-cause mortality. D-dimer predicts disease severity but not long-term prognosis in acute PE, possibly due to a more aggressive treatment strategy in severely affected patients.

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The Association between the Pulmonary Arterial Obstruction Index and Atrial Size in Patients with Acute Pulmonary Embolism

Radiology Research and Practice ◽

10.1155/2019/6025931 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Taraneh Faghihi Langroudi ◽

Maryam Sheikh ◽

Mohammadreza Naderian ◽

Morteza Sanei Taheri ◽

Amir Ashraf-ganjouei ◽

...

Keyword(s):

Pulmonary Embolism ◽

Acute Pulmonary Embolism ◽

Multidetector Ct ◽

Control Group ◽

Chronic Obstructive ◽

Expert Radiologist ◽

Atrial Size ◽

Significant Difference ◽

Pulmonary Arterial ◽

Pulmonary Arterial Obstruction

Purpose. Pulmonary embolism (PE) is a common and potentially fatal form of venous thromboembolism. The aim of this study is to investigate the association between the pulmonary arterial obstruction index and atrial size in patients with acute pulmonary embolism. Basic Procedure. The study consisted of 86 patients with clinical symptoms of PE. Out of 86 individuals, 50 patients were diagnosed with PE and considered as the patient group. The others were considered as the control group. All patients were scanned by a multidetector CT scanner. Using the radiology workstation, an expert radiologist calculated the left atrium (LA) and right atrium (RA) areas from planimetric measurements obtained from free-hand delineation of the atrial boarders using an electronic pen. Quantitative volumetric measurements of LA and RA were obtained from original axial images. Main Findings. There were 25 males and 25 females with PE, who had a mean age of 58 years. There was not a significant difference in the positive history of diabetes mellitus, hypertension, asthma, chronic obstructive pulmonary diseases, ischemic heart disease, and smoking between patients and control group. There was a significant negative correlation between almost all LA measurements and the PAOI. RA area and volume had the highest area under the curves for recognizing larger clot burden. Principal Conclusions. A higher clot load is associated with a smaller LA size and increased RA/LA ratios, measured with CTPA. Atrial measurements are correlated with POAI, and they could be used as sensitive parameters in predicting heart failure in patients with PE.

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Pulmonary Arterial Obstruction Due to a Huge Sinus Venosus Remnant

Circulation ◽

10.1161/01.cir.98.11.1150 ◽

1998 ◽

Vol 98 (11) ◽

pp. 1150-1150 ◽

Cited By ~ 4

Author(s):

Vibeke E. Hjortdal ◽

Elisabeth V. Stenbøg ◽

Ole Kromann Hansen ◽

Keld E. Sørensen

Keyword(s):

Sinus Venosus ◽

Pulmonary Arterial ◽

Pulmonary Arterial Obstruction

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Pulmonary Embolic Disease

Chest Imaging ◽

10.1093/med/9780199858064.003.0024 ◽

2019 ◽

pp. 135-140

Author(s):

Constantine Raptis

Keyword(s):

Chest Pain ◽

Motion Artifacts ◽

Common Source ◽

Pulmonary Emboli ◽

Septic Emboli ◽

Iodinated Contrast ◽

Life Threatening ◽

Pulmonary Arterial ◽

Tumor Emboli ◽

Acute Pe

Pulmonary emboli (PE) range from asymptomatic to life-threatening and are a common source of clinical concern in patients presenting with chest pain and dyspnea. CT using a PE protocol has become the standard for the evaluation of this condition. CT findings include intraluminal filling defects, parenchymal changes of infarction and potentially signs of right heart strain. These must be distinguished from well-known artifacts, most notably bolus-related and motion artifacts. Signs of acute PE must also be distinguished from those related to chronic PE, septic emboli, tumor emboli, chemical emboli and intraarterial thrombi. MR and nuclear studies may be useful in certain patients (e.g, young and those with allergies to iodinated contrast) and in those with certain suspected conditions (such as primary pulmonary arterial tumors or macroscopic tumor emboli).

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