Association between pulmonary arterial obstruction index and right lateral ventricular wall thickness with in-hospital m
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ORIGINAL ARTICLE
Association between pulmonary arterial obstruction index and right lateral ventricular wall thickness with in-hospital mortality in patients with acute pulmonary embolism Taraneh Faghihi Langroudi 1 & Abbas Arjmand Shabestari 1 & Shahrzad Hekmati 1 & Ramin Pourghorban 2 Received: 28 August 2020 / Accepted: 6 November 2020 # American Society of Emergency Radiology 2020
Abstract Purpose To retrospectively assess the correlation between pulmonary arterial obstruction index (PAOI) and right lateral ventricular wall thickness with in-hospital mortality in patients with acute pulmonary embolism. Methods CT angiography (CTA) of 55 consecutive patients (30 males; 25 females; mean age ± SD, 59 ± 11 years) with proven acute pulmonary embolism was investigated. PAOI was determined according to the Qanadli score on CTA. Right ventricular lateral wall thickness was also measured, and patients’ in-hospital mortality was recorded. The correlation between PAOI and mortality, right ventricular lateral wall thickness and mortality, and PAOI and right ventricular lateral wall thickness was evaluated. Results PAOI was 23.6 and 10.4 in patients with and without in-hospital mortality, respectively (P < 0.001). Right ventricular lateral wall thickness was 8.7 mm and 7.5 mm in patients with and without in-hospital mortality, respectively (P < 0.001). PAOI more than 21.5 and right ventricular lateral wall thickness more than 8.75 were predictive of in-hospital mortality with a high accuracy. Also, PAOI and right ventricular lateral wall thickness had a significant correlation with each other (P < 0.001; r = 0.695). Conclusion PAOI and right ventricular lateral wall thickness on CTA were highly predictive of in-hospital mortality in patients with pulmonary embolism. Right ventricular lateral wall thickness and PAOI had a significant correlation with each other as well. Keywords Angiography . CT . Chest . Embolism . Pulmonary artery obstruction index
Introduction Pulmonary thromboembolism is a common cardiovascular disorder with a mortality rate of 30% if left untreated. Even
* Shahrzad Hekmati [email protected] Taraneh Faghihi Langroudi [email protected] Abbas Arjmand Shabestari [email protected] Ramin Pourghorban [email protected] 1
Department of Radiology, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
when it is properly treated, the mortality rate approaches to 7% in hemodynamically stable patients [1]. Mortality could be the result of pulmonary arterial hypertension and an increase in pressure overload of the right ventricle. Although echocardiography has been considered useful modality in the detection of right ventricular failure, computed tomography angiography (CTA) could be used not only to diagnose pulmonary thromboembolism but also to predict the severity of pulmonary artery obstruction and patients’ mortality. The correlation between several CT and CTA features, i
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