Saddle Pulmonary Embolism: Laboratory and Computed Tomographic Pulmonary Angiographic Findings to Predict Short-term Mortality

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• 作者：Min Liu ; MD^a ; ¹ ; ^{drradiology@163.com} ; Ran Miao ; PhD^b ; Xiaojuan Guo ; MD^a ; Li Zhu ; MD^c ; Hongxia Zhang ; MD^d ; Qing Hou ; MD^e ; Youmin Guo ; MD^f ; Yuanhua Yang ; MD^g
• 关键词：Saddle Pulmonary Embolism ; Computed tomographic pulmonary angiography ; N-terminal pro-brain natriuretic peptide ; Cardiac troponin I ; Short-term mortality
• 刊名：Heart, Lung and Circulation
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：26
• 期：2
• 页码：134-142
• 全文大小：1195 K
• 卷排序：26

文摘

Saddle pulmonary embolism (SPE) is rare type of acute pulmonary embolism and there is debate about its treatment and prognosis. Our aim is to assess laboratory and computed tomographic pulmonary angiographic (CTPA) findings to predict short-term mortality in patients with SPE.MethodsThis was a five-centre, retrospective study. The clinical information, laboratory and CTPA findings of 88 consecutive patients with SPE were collected. One-month mortality after diagnosis of SPE was the primary end-point. The correlation of laboratory and CTPA findings with one-month mortality was analysed with area under curve (AUC) of receiver operating characteristic (ROC) curves and logistic regression analysis.ResultsEighteen patients with SPE died within one month. Receiver operating characteristic curves revealed that the cutoff values for the right and left atrial diameter ratio, the right ventricular area and left ventricular area ratio (RVa/LVa ratio), Mastora score, septal angle, N-terminal pro-brain natriuretic peptide and cardiac troponin I (cTnI) for detecting early mortality were 2.15, 2.13, 69%, 57°, 3036 pg/mL and 0.18 ng/mL, respectively. Using logistic regression analysis of laboratory and CTPA findings with regard to one-month mortality of SPE, RVa/LVa ratio and cTnI were shown to be independently associated with early death. A combination of cTnI and RVa/LVa ratio revealed an increase in the AUC value, but the difference did not reach significance compared with RVa/LVa or cTnI, alone (P>0.05).ConclusionIn patients with SPE, both the RVa/LVa ratio on CTPA and cTnI appear valuable for the prediction of short-term mortality.