Prognostic value of cardiovascular parameters in computed tomography pulmonary angiography in patients with acute pulmonary embolism

The European Respiratory Journal
Ludo F M BeenenSaskia Middeldorp

Abstract

The value of various computed tomography parameters for prognosis and risk stratification in acute pulmonary embolism is controversial. Our objective was to evaluate the impact of specific cardiovascular computed tomography pulmonary angiography parameters on short- and long-term clinical outcomes.We analysed radiological and clinical data of 1950 patients with acute pulmonary embolism who participated in an international randomised clinical trial on anticoagulants. Parameters included right/left ventricular ratio, septal bowing, cardiothoracic ratio, diameters of pulmonary trunk and aorta, and intrahepatic/azygos vein contrast medium backflow. Associations with mortality, recurrent venous thromboembolism (VTE), hospitalisation, bleeding and adverse events were assessed over the short term (1 week and 1 month) and long term (12 months).Pulmonary trunk enlargement was the only parameter significantly associated with mortality over both the short and long term (OR 4.18 (95% CI 1.04-16.76) at 1 week to OR 2.33 (95% CI 1.36-3.97) after 1 year), as well as with recurrent VTE and hospitalisation.Most of the evaluated radiological parameters do not have strong effects on the short- or long-term outcome in patients with acute pulmonary...Continue Reading

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Citations

Sep 2, 2020·International Journal of Emergency Medicine·Omran Al DandanHind S Alsaif
Sep 29, 2021·Radiology·Andetta R Hunsaker

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