Greater total embolic volume measured by 3D CT was independently associated with an increased risk of impending shock (OR 2.28 per 10 cm3 increment) in patients with acute pulmonary embolism.
Observational (n=201)
No
Does total embolic volume assessed by CT predict right ventricular dysfunction and impending shock in patients with acute pulmonary embolism?
Total embolic volume measured by CT is an independent predictor of right ventricular dysfunction and impending shock in patients with acute pulmonary embolism.
Odds Ratio: 2.28 (95% CI 1.27–4.29)
p-value: p=0.007
Detailed descriptions of acute pulmonary emboli (PE) morphology, total embolic volume (TEV), and their effects upon patients' clinical presentation and prognosis remain largely unexplored. We studied 201 subjects with acute PE to the emergency department of a single medical center from April 2009 to December 2014. Patient hemodynamics, Troponin I and D-dimer levels, echocardiography, and the 30-day, 90-day and long-term mortality were obtained. Contrast-enhanced computed tomography (CT) of pulmonary structures and 3-dimensional measures of embolic burden were performed. The results showed a linear association between the greater TEV and each of the following 4 variables (increasing incidence of right ventricular (RV) dysfunction, higher systolic pulmonary artery pressure (sPAP), greater RV diameter, and RV/left ventricular (LV) ratio (all p < 0.001)). Among the measures of CT and echocardiography, TEV and RV/LV ratio were significantly associated with impending shock. In backward stepwise logistic regression, TEV, age and respiratory rate remained independent associated with impending shock (OR: 1.58, 1.03, 1.18, respectively and all p < 0.005).Total embolic burden assessed by CT-based quantification serves as a useful index for stressed cardiopulmonary circulation condition and can provide insights into RV dysfunction and the prediction of impending shock.
Huang et al. (Tue,) conducted a observational in Acute pulmonary embolism (n=201). Total embolic volume (TEV) vs. Lower total embolic volume was evaluated on Impending shock (normotension at arrival and subsequent development of hypotension requiring vasopressor) (OR 2.28, 95% CI 1.27-4.29, p=0.007). Greater total embolic volume measured by 3D CT was independently associated with an increased risk of impending shock (OR 2.28 per 10 cm3 increment) in patients with acute pulmonary embolism.