[Right-ventricular dysfunction and the pulmonary vascular obstruction index: predictable variables of the clinical course over 3 months in patients with acute lung emboli]. / Rechterventrikeldisfunctie en index voor pulmonale vasculaire obstructie: voorspellende variabelen voor het klinische beloop gedurende 3 maanden bij patiënten met acute longembolie.
Ned Tijdschr Geneeskd
; 150(15): 845-50, 2006 Apr 15.
Article
em Nl
| MEDLINE
| ID: mdl-16676515
ABSTRACT
OBJECTIVE:
To quantify right-ventricular dysfunction and the pulmonary artery obstruction index, in patients with acute pulmonary embolism, using helical CT, and to assess the prognostic value of these parameters.DESIGN:
Prospective.METHOD:
In 120 consecutive patients with proven acute pulmonary embolism, the extent of right-ventricular dysfunction was assessed by quantifying the ratios of the right to left-ventricular short-axis diameters (RV/LV ratio) and the extent ofobstruction ofthe pulmonary-artery circulation by using helical CT images. Regression analysis was used to correlate these parameters with patient outcome.RESULTS:
Right-ventricular dysfunction (RV/LV ratio > 1.0) was seen in 69 patients (57.5%). Seven patients died as a direct result of pulmonary embolism. Both the RV/LV ratio and the obstruction index were significant risk factors for mortality within three months (p = 0.04 and 0.01 respectively). The positive predictive value for pulmonary embolism-related mortality of an RV/LV ratio > 1.0 was 10.1% (95% CI 2.9-17.4). The negative predictive value for an uneventful outcome of an RV/LV ratio < or = 1.0 was 100% (95% CI 94.3-100). There was a 11.2-fold risk of dying of pulmonary embolism in patients with an obstruction index > or = 40% (95% CI 1.3-93.6).CONCLUSION:
Markers of right-ventricular dysfunction and pulmonary vascular obstruction, assessed by helical CT-examination at baseline, help to predict mortality during follow-up of patients with acute pulmonary embolism.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Embolia Pulmonar
/
Disfunção Ventricular Direita
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Tomografia Computadorizada Espiral
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
Nl
Revista:
Ned Tijdschr Geneeskd
Ano de publicação:
2006
Tipo de documento:
Article