PMID- 37548900
OWN - NLM
STAT- MEDLINE
DCOM- 20231005
LR  - 20231005
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 56
IP  - 4
DP  - 2023 Nov
TI  - Predictive value of reduced pulmonary arterial elasticity in acute pulmonary 
      embolism for right ventricular dysfunction.
PG  - 529-537
LID - 10.1007/s11239-023-02873-z [doi]
AB  - BACKGROUND: Computed tomography pulmonary angiography (CTPA) yields indices, such 
      as the right ventricular/left ventricular (RV/LV) ratio > 1.0, which are commonly 
      used for risk stratification of patients with acute pulmonary embolism (APE). 
      Although pulmonary artery elasticity (PAE) has been previously described, its 
      relationship with right ventricular dysfunction (RVD) has not been explored. 
      Here, we investigated whether PAE, measured using CTPA, is associated with RVD. 
      METHODS: Patients who underwent retrospective electrocardiogram-gated CTPA and 
      had a definitive diagnosis of APE were included in the study. The subjects were 
      classified into RVD and non-RVD groups according to the RVD on echocardiography. 
      PAE, involving aortic distensibility (AD), aortic compliance (AC), and aortic 
      stiffness (ASI), and right heart function indices were compared between the two 
      groups, and their correlations were examined. Receiver operating characteristic 
      (ROC) curves were generated to evaluate the specificity and sensitivity of the 
      RVD prediction. RESULTS: Thirty-five patients with APE were enrolled in the study 
      (RVD: 18, non-RVD: 17). The groups showed no significant differences in age, sex, 
      number of patients receiving thrombolysis, and number of high-risk conditions 
      (P > 0.05). Regarding PAE parameters, AD was significantly reduced in the RVD 
      group compared to that in the non-RVD group (P < 0.05), whereas AC and ASI were 
      not statistically different (P > 0.05). The ratio of the maximum cross-sectional 
      area of PA and AA (PA/AAmax),the ratio of the minimum cross-sectional area of PA 
      and AA(PA/AAmin), diameter of the coronary sinus, RV/LV diameter, RV/Lvarea, the 
      ratio of the end-diastolic volume of right ventricular and left ventricular 
      (RV/LV(DV)), the ratio of the end-systolic volume of right ventricular and left 
      ventricular (RV/LV(SV)) were significantly greater in the RVD group than in the 
      non-RVD group (P < 0.05). Correlation analysis of AD and right heart function 
      parameters showed that AD was negatively correlated with PA/AAmax, PA/AAmin, 
      RV/LV diameter, RV/LV(DV), and PAE measured by ultrasound, with correlation 
      coefficients ranging from - 0.336 to - 0.580 (P < 0.05). The ROC curves of AD and 
      RV/LVdiameter to predict RVD had areas under the curve of 0.748 and 0.712, 
      sensitivities of 82.35% and 70.59%, specificities of 66.67% and 72.22%, and 
      cutoff values of 4.9433 and 1.1105, respectively. CONCLUSION: AD obtained by 
      retrospective ECG-gated CTPA may be helpful in assessing RVD in patients with APE 
      while accurately diagnosing APE. It contributes to timely diagnosis and treatment 
      and improves the prognosis of patients with APE.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Yang, Fei
AU  - Yang F
AD  - Department of Medical Imaging, the First Affiliated Hospital of Hebei North 
      University, Zhangjiakou, Hebei, 075000, China.
FAU - Chen, Rong
AU  - Chen R
AD  - Hebei North University, Zhangjiakou, Hebei, 075000, China.
FAU - Yang, Zhixiang
AU  - Yang Z
AD  - Hebei North University, Zhangjiakou, Hebei, 075000, China.
FAU - Yang, Yue
AU  - Yang Y
AD  - Hebei North University, Zhangjiakou, Hebei, 075000, China.
FAU - Cui, Shujun
AU  - Cui S
AD  - Department of Medical Imaging, the First Affiliated Hospital of Hebei North 
      University, Zhangjiakou, Hebei, 075000, China.
FAU - Ma, Yongqing
AU  - Ma Y
AD  - Department of Medical Imaging, the First Affiliated Hospital of Hebei North 
      University, Zhangjiakou, Hebei, 075000, China.
FAU - Wang, Dawei
AU  - Wang D
AD  - Department of Thoracic Surgery, the First Affiliated Hospital of Hebei North 
      University, Zhangjiakou, Hebei, 075000, China. 15530392140@163.com.
LA  - eng
GR  - 21377769D/Science and Technology Project of the Hebei Provincial Science and 
      Technology Department/
PT  - Journal Article
DEP - 20230807
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
SB  - IM
MH  - Humans
MH  - Animals
MH  - Pulmonary Artery/diagnostic imaging
MH  - Retrospective Studies
MH  - *Ventricular Dysfunction, Right
MH  - *Hypertension, Pulmonary
MH  - *Pulmonary Embolism/diagnostic imaging/complications
MH  - *Hominidae
OTO - NOTNLM
OT  - Acute pulmonary embolism
OT  - CT pulmonary angiography
OT  - ECG-gating
OT  - Pulmonary artery elasticity
OT  - Right ventricular dysfunction
EDAT- 2023/08/07 13:10
MHDA- 2023/10/05 06:44
CRDT- 2023/08/07 11:15
PHST- 2023/07/16 00:00 [accepted]
PHST- 2023/10/05 06:44 [medline]
PHST- 2023/08/07 13:10 [pubmed]
PHST- 2023/08/07 11:15 [entrez]
AID - 10.1007/s11239-023-02873-z [pii]
AID - 10.1007/s11239-023-02873-z [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2023 Nov;56(4):529-537. doi: 10.1007/s11239-023-02873-z. 
      Epub 2023 Aug 7.