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The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism

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Abstract

Purpose

To evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE).

Materials and methods

A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. RVD was assessed by echocardiography. The patients were divided into two groups based on the presence or absence of RVD.

Results

RV/LV ratio, SVC axial diameter, PA axial diameter, and Miller, Qanadli, and Mastora scores were significantly increased in the RVD group. Multivariate logistic regression analysis showed that RV/LV ratio [OR 6.36 (2.02–279.46 95 % CI), p = 0.01] and PA axial diameter [OR 5.02 (1.02–1.26 95 % CI), p = 0.03] were independent predictors of echocardiographic RVD. Predictive values of these parameters were improved when combined with other intragroup cutoff values. A cutoff value for the RV/LV ratio of >1.08 had 81.43 % sensitivity, 52.08 % specificity, 71.3 PPV, and 65.8 NPV for prediction of RVD.

Conclusion

Tomographic axial diameters enable more accurate predictions of RVD than OS scores do.

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Acknowledgments

In this study, Alpay Aribas, Suat Keskin, and Hakan Akilli contributed to the study design, performed research, analyzed data, and wrote the paper, Mehmet Kayrak contributed to the study design, performed research, and analyzed data, Halil İbrahim Erdogan and Oguzhan Yildirim contributed to data collection and performed research, and Ibrahim Guler and Taha Tahir Bekci performed research and analyzed data.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Cardiology, Necmettin Erbakan University Meram School of Medicine Hospital, Meram, 42080, Konya, Turkey

    Alpay Aribas, Hakan Akilli, Mehmet Kayrak, Halil Ibrahim Erdogan & Oguzhan Yildirim

  2. Department of Radiology, Necmettin Erbakan University Meram School of Medicine Hospital, Meram, Konya, Turkey

    Suat Keskin

  3. Department of Radiology, Konya Education and Research Hospital, Meram, Konya, Turkey

    Ibrahim Guler

  4. Department of Pulmonary Medicine, Konya Education and Research Hospital, Meram, Konya, Turkey

    Taha Tahir Bekci

Authors
  1. Alpay Aribas
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  2. Suat Keskin
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  3. Hakan Akilli
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  5. Halil Ibrahim Erdogan
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  6. Ibrahim Guler
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  7. Oguzhan Yildirim
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  8. Taha Tahir Bekci
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Corresponding author

Correspondence to Alpay Aribas.

Additional information

The present manuscript was accepted for oral presentation at the 29th Turkish Cardiology Congress with International Participation (held 26–29 October 2013) and was published in the online version of the Journal of the American College of Cardiology (JACC) on 29 October 2013.

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Aribas, A., Keskin, S., Akilli, H. et al. The use of axial diameters and CT obstruction scores for determining echocardiographic right ventricular dysfunction in patients with acute pulmonary embolism. Jpn J Radiol 32, 451–460 (2014). https://doi.org/10.1007/s11604-014-0327-8

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  • DOI: https://doi.org/10.1007/s11604-014-0327-8

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