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Clot burden score in the evaluation of right ventricular dysfunction in acute pulmonary embolism: Quantifying the cause and clarifying the consequences

2012; Elsevier BV; Volume: 31; Issue: 11 Linguagem: Inglês

10.1016/j.repce.2012.09.005

2174-2049

Bruno Lima Rodrigues, Hildeberto Correia, Ângela Figueiredo, Anne Delgado, Davide Moreira, Luís Ferreira dos Santos, Emanuel Peres, João Pipa, Ilídio Beirão, Oliveira Santos,

Atrial Fibrillation Management and Outcomes

Pulmonary angiography by computed tomography (CT) is the method of choice for the detection of acute pulmonary embolism (PE). Studies have shown that the severity of PE can be estimated by clot burden scores. To evaluate the correlation between an angiographic clot burden score (Qanadli score–QS) and parameters of right ventricular dysfunction (RVD) in patients admitted for PE. We performed a retrospective study of 107 patients (60% female) admitted to an intensive care unit for PE (intermediate/high risk) between January 1, 2007 and September 30, 2011. Images from 16-slice multidetector CT angiography were reviewed in 102 patients and the QS calculated. Based on a cut-off of 18 points established by ROC curve analysis, two groups were formed (A 18 was an independent predictor of RVD (RV/LV ratio >1) (OR: 10.85; p <0.001) (area under the curve on ROC analysis: 0.79; p 18 points proved to be an independent predictor of RVD in PE, and correlated linearly with variables associated with higher morbidity and mortality. A angio-TC pulmonar é o método de escolha para o diagnóstico de tromboembolismo pulmonar (TEP). Estudos têm demonstrado que a gravidade do TEP poderá ser estimada com sistemas de quantificação de carga embólica. Avaliar a correlação entre um score de carga embólica angiográfica (Qanadli score – QS), com os parâmetros de disfunção ventricular direita (DVD), em pacientes com TEP. Estudo retrospetivo de 107 pacientes (feminino – 60%), admitidos por TEP (intermédio/elevado risco) numa UCIC (1/1/2007-30/9/2011). Revistas as imagens de angio-TC de 102 pacientes (TCMD-16C) e quantificado o QS. Estabelecido cut-off de 18 pontos por curva ROC. Constituídos 2 grupos (G) (A 18 preditor independente de DVD (VD/VE> 1) (OR:10,85;p <0,001) (AUC-ROC: 0,79; p 18 pontos revelou-se preditor independente de DVD no TEP, correlacionando-se linearmente com multivariáveis associadas a morbi/mortalidade mais elevada.