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. 2021 Apr;49(4):3000605211004769.
doi: 10.1177/03000605211004769.

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

Yunqiang Nie  1 , Li Sun  2 , Wei Long  3 , Xin Lv  1 , Cuiyun Li  1 , Hui Wang  1 , Xing Li  1 , Ping Han  1 , Miao Guo  4
Affiliations

Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

Yunqiang Nie et al. J Int Med Res. 2021 Apr.

Abstract

Objective: To explore the clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism (APE).

Methods: Sixty-four patients with APE were classified into mixed-type and distal-type pulmonary embolism groups. Their right ventricular systolic pressure (RVSP) and disease duration were recorded, and the diameter of their right ventricles was measured by ultrasound. The computed tomography angiographic clot load was determined as a Mastora score.

Results: Patients with distal-type pulmonary embolisms had significantly lower RVSPs (44.92 ± 17.04 vs 55.69 ± 17.66 mmHg), and significantly smaller right ventricular diameters (21.08 ± 3.06 vs 23.37 ± 3.48 mm) than those with mixed-type pulmonary embolisms. Additionally, disease duration was significantly longer in patients with distal-type pulmonary embolisms (14.33 ± 11.57 vs 8.10 ± 7.10 days), and they had significantly lower Mastora scores (20.91% ± 18.92% vs 43.96% ± 18.30%) than patients with mixed-type pulmonary embolisms. After treatment, RVSPs decreased significantly in patients with both distal-type and mixed-type pulmonary embolisms. Right ventricle diameters also decreased significantly in patients with mixed-type pulmonary embolisms after treatment.

Conclusion: Patients with mixed-type pulmonary embolisms are significantly more susceptible to pulmonary hypertension, enlarged right ventricular diameters, and shorter durations of disease than those with distal-type pulmonary embolisms. The distribution of pulmonary artery embolism in APE can provide a clinical reference.

Keywords: Mastora score; Pulmonary artery; pulmonary embolism; pulmonary hypertension; ventricular diameter; ventricular systolic pressure.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
CT characteristics of a patient with a distal-type pulmonary embolism. No thrombus was seen in the left and right pulmonary arteries or lobar arteries (a). A pulmonary artery embolus was distributed mainly in the pulmonary segment arteries (b). Red arrows represent embolisms. CT, computed tomography.
Figure 2.
Figure 2.
CT characteristics of a patient with a mixed-type pulmonary embolism. The embolism was shown to be distributed in left and right pulmonary arteries (a), as well as left and right pulmonary lobe arteries, and pulmonary segment arteries (b). Red arrows represent embolisms. CT, computed tomography.
See this image and copyright information in PMC

References

    1. Doğan H, De Roos A, Geleijins J, et al. The role of computed tomography in the diagnosis of acute and chronic pulmonary embolism. Diagn Interv Radiol 2015; 21: 307–316. DOI:10.5152/dir.2015.14403 - PMC - PubMed
    1. Konstantinides SV. 2014 ESC guidelines on the diagnosis and management of acute pulmonaryembolism. Eur Heart J 2014; 35: 3145–3146. - PubMed
    1. Mastora I, Remy-Jardin M, Masson P, et al. Severity of acute pulmonary embolism: evaluation of a new spiral CT angiographic score in correlation with echocardiographic data. Eur Radiol 2003; 13: 29–35. - PubMed
    1. Guérin L, Couturaud F, Parent F, et al. Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Thromb Haemost 2014; 112: 598–605. - PubMed
    1. Pengo V, Lensing AWA, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004; 350: 2257–2264. - PubMed