Evaluation Of Right Ventricular Function In Patients With Acute Pulmonary Embolism With CT Pulmonary Artery Obstruction Index

[Objective] To evaluate the right ventricular function in patients with acute pulmonary embolism (APE) with CT pulmonary artery obstruction index (PAOI) by analyzing CT pulmonary angiography (CTPA),ultrasound cardiogram (UCG) and blood gas analysis of patients with acute pulmonary embolism.[Methods] Fifty-four patients were included in this study. All patients had been excluded severe underlying cardiopulmonary disease, bleeding, recently anticoagulant therapy and history of chronic thromboembolic disease and had done computed tomogra-phy, blood gas analysis and echocardiography, diagn-osed as APE with CTPA during hospitalizing in the Department of Respiratory Medicine of the second affiliated hospital of Kunming Medical University during Dec.2011to Dec.2012. Analyze the data of CTPA,UCG and blood gas analysis of54patients with APE.Estimate PAOI on the basis of the degree of obstruction and location of the thrombus on CT imaging accroding to the method described by Qanadli etc. Also the right ventricular function pa-rameters which included cardiac diameters and vascular diameters should be measured by CT imgaes synchronously. The cardiac diameters include right ventricular short axis diameter(RVd),left ventricular short axis diameter(LVd) and RVd/LVd.The vascular diameters include main pulmonary artery diameter (MPA) and superior vena cava diameter(SVC). The54patients were divided into mild, moderate or severe categories according to PAOI<30%,30%≤PAOI<50%and PAOI≥50%. Analyze the differences of the right ventricular function parameters measured both by CT images and UCG between mild, moderate or severe groups separ-ately. Also analyze the differe-nces of the volume both in arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2) between the three categories. Then make a analysis about the correlation between the right ventricular function para-meters measured both by CT images and UCG.[Results] According to CT pulmonary embolism index,54patients were divided into mild (36cases), moderate (13cases) and severe (5cases) groups.1. Comparison of the measurement data of the right heart function parameters measured by CT images among the three groups.Comparison of the cardiac diameters between mild, moderate and severe groups showed significant differences (P<0.05) in RVd, LVd, RVd/LVd, MPA and SVC.Compared with mild group, moderate and severe groups showed an increasing trend in RVd, RVd/LVd, MPA and SVC, but a decreasing trend in LVd.2. Comparison of the measurement data of the right heart function parameters measured by UCG among the three groups.Comparison of the cardiac diameters between mild, moderate and severe groups showed significant differences (P<0.05) in RVd, LVd, and RVd/LVd.Compared with mild group, moderate and severe groups showed an increasing trend in RVd and RVd/LVd, but a decreasing trend in LVd.3. Comparison of the data both in PaO2and PaCO2among the three groups by blood gas analysis.Comparison of the data in PaO2, PaCO2between mild, moderate and severe groups showed significant differences (P<0.05).Compared with mild group, moderate and severe groups showed an decreasing trend in PaO2and PaCO2.4. Analyze the correlation between the right ventricular function parameters measured both by CT images and UCG.The result showed positive correlation between the right ventricular function parameters measured both by CT images and UCG.[Conclusion] The study showed CTPA obstruction index can reflect the right heart function of acute pulmonary embolism, being prompt to conf-irm the extent of APE in the first time.