RESUMO
Right ventricular dysfunction (RVD) defined by echocardiography and/or by natriuretic peptides is a well-known predictor of prognosis in patients with pulmonary embolism (PE). This study investigated carbonic anhydrase IX (CA IX) levels for predicting echocardiographic RVD in patients with PE. A total of 150 normotensive patients with PE were included. The levels of CA IX, N-terminal pro-brain-type natriuretic peptide (NT-proBNP), and high-sensitive cardiac troponin T were significantly elevated in patients with PE with RVD on echocardiography. A receiver-operating characteristic curve analysis showed a value of 0.751 for CA IX, 0.714 for NT-proBNP, and 0.650 for high-sensitive troponin-T to predict RVD on echocardiography. The cutoff value to predict RVD was 32.45 pg/mL for CA IX (sensitivity: 89.3% and specificity: 51.1%). There was a significant positive correlation between the CA IX level and the systolic pulmonary arterial pressure on echocardiography (ρ = .21; P = .035). The CA IX is a significant serologic predictor of RVD in acute PE and correlates with systolic pulmonary arterial pressure.
Assuntos
Antígenos de Neoplasias/sangue , Anidrases Carbônicas/sangue , Embolia Pulmonar/complicações , Disfunção Ventricular Direita/etiologia , Doença Aguda , Adulto , Idoso , Anidrase Carbônica IX , Ecocardiografia , Feminino , Hemodinâmica , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Embolia Pulmonar/fisiopatologia , Troponina T/sangue , Disfunção Ventricular Direita/sangue , Disfunção Ventricular Direita/enzimologia , Disfunção Ventricular Direita/fisiopatologiaRESUMO
Inflammatory myofibroblastic tumor of the trachea is a rare benign tumor in adults. It is mostly seen before the age of 16. We describe a 20-year-old female patient who presented with stridor. She had a fixed obstruction on spirometry, and computed tomography and bronchoscopy confirmed tracheal thickening and stenosis below the vocal cords and bronchial wall thickening at the level of the carina. Bronchoscopic biopsy confirmed an inflammatory myofibroblastic tumor. She recovered after mechanical dilatation and resection via rigid bronchoscopy, followed by corticosteroid therapy.