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. 2023 Jul-Aug;40(4):306-311.
doi: 10.4103/lungindia.lungindia_357_22.

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

Oisin O'Corragain  1 , Rami Alashram  1 , Gregory Millio  2 , Catherine Vanchiere  2 , John Hojoon Hwang  2 , Maruti Kumaran  3 , Chandra Dass  3 , Huaqing Zhao  4 , Joseph Panero  3 , Vlad Lakhter  5 , Rohit Gupta  1 , Riyaz Bashir  5 , Gary Cohen  3 , David Jimenez  6 , Gerard Criner  1 , Parth Rali  1
Affiliations

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

Oisin O'Corragain et al. Lung India. 2023 Jul-Aug.

Abstract

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.

Keywords: Echocardiography; pulmonary embolism; right ventricular dysfunction.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
PA diameter measurement on CTPA
Figure 2
Figure 2
Risk of early (in-hospital or 30 day) death as per ESC guideline classification
Figure 3
Figure 3
Correlation between the PA diameter and the right ventricular systolic pressure and TAPSE
Figure 4
Figure 4
ROC curves (a) RV dilation; (b) RV systolic dysfunction; (c) RVSP; (d) TAPSE
See this image and copyright information in PMC

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