Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism

Introduction: Right ventricular dysfunction (RVD) is a key component in the process of risk stratification in patients with acute pulmonary embolism (PE). Echocardiography remains the gold standard for RVD assessment, however, measures of RVD may be seen on CTPA imaging, including increased pulmona...

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Main Authors: Oisin O'Corragain, Rami Alashram, Gregory Millio, Catherine Vanchiere, John Hojoon Hwang, Maruti Kumaran, Chandra Dass, Huaqing Zhao, Joseph Panero, Vlad Lakhter, Rohit Gupta, Riyaz Bashir, Gary Cohen, David Jimenez, Gerard Criner, Parth Rali
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Lung India
Subjects:
Online Access:http://www.lungindia.com/article.asp?issn=0970-2113;year=2023;volume=40;issue=4;spage=306;epage=311;aulast=O'Corragain
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author Oisin O'Corragain
Rami Alashram
Gregory Millio
Catherine Vanchiere
John Hojoon Hwang
Maruti Kumaran
Chandra Dass
Huaqing Zhao
Joseph Panero
Vlad Lakhter
Rohit Gupta
Riyaz Bashir
Gary Cohen
David Jimenez
Gerard Criner
Parth Rali
author_facet Oisin O'Corragain
Rami Alashram
Gregory Millio
Catherine Vanchiere
John Hojoon Hwang
Maruti Kumaran
Chandra Dass
Huaqing Zhao
Joseph Panero
Vlad Lakhter
Rohit Gupta
Riyaz Bashir
Gary Cohen
David Jimenez
Gerard Criner
Parth Rali
author_sort Oisin O'Corragain
collection DOAJ
description Introduction: Right ventricular dysfunction (RVD) is a key component in the process of risk stratification in patients with acute pulmonary embolism (PE). Echocardiography remains the gold standard for RVD assessment, however, measures of RVD may be seen on CTPA imaging, including increased pulmonary artery diameter (PAD). The aim of our study was to evaluate the association between PAD and echocardiographic parameters of RVD in patients with acute PE. Methods: Retrospective analysis of patients diagnosed with acute PE was conducted at large academic center with an established pulmonary embolism response team (PERT). Patients with available clinical, imaging, and echocardiographic data were included. PAD was compared to echocardiographic markers of RVD. Statistical analysis was performed using the Student's t test, Chi-square test, or one-way analysis of variance (ANOVA); P < 0.05 was considered statistically significant. Results: 270 patients with acute PE were identified. Patients with a PAD >30 mm measured on CTPA had higher rates of RV dilation (73.1% vs 48.7%, P < 0.005), RV systolic dysfunction (65.4% vs 43.7%, P < 0.005), and RVSP >30 mmHg (90.2% vs 68%, P = 0.004), but not TAPSE ≤1.6 cm (39.1% vs 26.1%, P = 0.086). A weak increasing linear relationship between PAD and RVSP was noted (r = 0.379, P = 0.001). Conclusions: Increased PAD in patients with acute PE was significantly associated with echocardiographic markers of RVD. Increased PAD on CTPA in acute PE can serve as a rapid prognostic tool and assist with PE risk stratification at the time of diagnosis, allowing rapid mobilization of a PERT team and appropriate resource utilization.
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spelling doaj.art-1499b99c86c34f95969c6c5a9d769da62023-07-23T11:52:56ZengWolters Kluwer Medknow PublicationsLung India0970-21130974-598X2023-01-0140430631110.4103/lungindia.lungindia_357_22Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolismOisin O'CorragainRami AlashramGregory MillioCatherine VanchiereJohn Hojoon HwangMaruti KumaranChandra DassHuaqing ZhaoJoseph PaneroVlad LakhterRohit GuptaRiyaz BashirGary CohenDavid JimenezGerard CrinerParth RaliIntroduction: Right ventricular dysfunction (RVD) is a key component in the process of risk stratification in patients with acute pulmonary embolism (PE). Echocardiography remains the gold standard for RVD assessment, however, measures of RVD may be seen on CTPA imaging, including increased pulmonary artery diameter (PAD). The aim of our study was to evaluate the association between PAD and echocardiographic parameters of RVD in patients with acute PE. Methods: Retrospective analysis of patients diagnosed with acute PE was conducted at large academic center with an established pulmonary embolism response team (PERT). Patients with available clinical, imaging, and echocardiographic data were included. PAD was compared to echocardiographic markers of RVD. Statistical analysis was performed using the Student's t test, Chi-square test, or one-way analysis of variance (ANOVA); P < 0.05 was considered statistically significant. Results: 270 patients with acute PE were identified. Patients with a PAD >30 mm measured on CTPA had higher rates of RV dilation (73.1% vs 48.7%, P < 0.005), RV systolic dysfunction (65.4% vs 43.7%, P < 0.005), and RVSP >30 mmHg (90.2% vs 68%, P = 0.004), but not TAPSE ≤1.6 cm (39.1% vs 26.1%, P = 0.086). A weak increasing linear relationship between PAD and RVSP was noted (r = 0.379, P = 0.001). Conclusions: Increased PAD in patients with acute PE was significantly associated with echocardiographic markers of RVD. Increased PAD on CTPA in acute PE can serve as a rapid prognostic tool and assist with PE risk stratification at the time of diagnosis, allowing rapid mobilization of a PERT team and appropriate resource utilization.http://www.lungindia.com/article.asp?issn=0970-2113;year=2023;volume=40;issue=4;spage=306;epage=311;aulast=O'Corragainechocardiographypulmonary embolismright ventricular dysfunction
spellingShingle Oisin O'Corragain
Rami Alashram
Gregory Millio
Catherine Vanchiere
John Hojoon Hwang
Maruti Kumaran
Chandra Dass
Huaqing Zhao
Joseph Panero
Vlad Lakhter
Rohit Gupta
Riyaz Bashir
Gary Cohen
David Jimenez
Gerard Criner
Parth Rali
Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
Lung India
echocardiography
pulmonary embolism
right ventricular dysfunction
title Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
title_full Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
title_fullStr Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
title_full_unstemmed Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
title_short Pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
title_sort pulmonary artery diameter correlates with echocardiographic parameters of right ventricular dysfunction in patients with acute pulmonary embolism
topic echocardiography
pulmonary embolism
right ventricular dysfunction
url http://www.lungindia.com/article.asp?issn=0970-2113;year=2023;volume=40;issue=4;spage=306;epage=311;aulast=O'Corragain
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