经胸超声心动图与计算机断层扫描肺血管造影在检测肺栓塞右心室功能障碍方面的一致性。

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Serhat Erol, Aslıhan Gürün Kaya, Fatma Arslan, Sümeyye Ayöz, Ayşegül Gürsoy Çoruh, Melahat Kul, Evren Özçınar, Aydın Çiledağ, Zeynep Pınar Önen, Akın Kaya, Özlem Özdemir Kumbasar, Stavros V Konstantinides
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引用次数: 0

摘要

背景:右心室功能障碍(RVD)是肺栓塞(PE)患者死亡率的主要决定因素。因此,指南建议通过经胸超声心动图(TTE)或计算机断层扫描肺动脉造影(CTPA)对这些患者的 RVD 进行评估。在这项研究中,我们调查了 TTE 和 CTPA 在检测 RVD 方面的一致性:这项单中心回顾性研究纳入了经 CTPA 诊断并在诊断后 24 小时内接受 TTE 检查的患者:结果:258 名患者符合纳入标准。其中 71.3%(184 人)的 CTPA 和 TTE 就是否存在 RVD 达成一致。这两项检查的一致性达到中等水平(Cohen's kappa = 0.404,P 结论:CTPA 和 TTE 都是可靠的诊断方法:CTPA 和 TTE 都是检测 RVD 的可靠成像模式。然而,TTE 的特异性更高,这可能有助于识别和适当处理失代偿风险较高的患者。结合 CTPA 参数而非单个 RV/LV 比值可提高 CTPA 的灵敏度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Agreement Between Transthoracic Echocardiography and Computed Tomography Pulmonary Angiography for Detection of Right Ventricular Dysfunction in Pulmonary Embolism.

Background: Right ventricular dysfunction (RVD) is the main determinant of mortality in patients with pulmonary embolism (PE). Thus, guidelines recommend the assessment of RVD with transthoracic echocardiography (TTE) or computed tomography pulmonary angiography (CTPA) among these patients. In this study, we investigated the agreement between TTE and CTPA for the detection of RVD.

Methods: This single-center retrospective study included patients who were diagnosed with CTPA and underwent TTE within the first 24 hours following the diagnosis.

Results: Two hundred fifty-eight patients met the inclusion criteria. In 71.3% (184) of them, CTPA and TTE agreed on both the presence and absence of RVD. There was a moderate agreement between the 2 tests (Cohen's kappa = 0.404, P <.001). The agreement between right ventricle dysfunction on TTE and the increased right ventricle/left ventricle (RV/LV) on CTPA was fair (Cohen's kappa = 0.388, P <.001). Three patients died due to PE, and another 5 patients required urgent reperfusion therapy. Overall, adverse outcomes occurred in 4% (8) of patients. The sensitivity of modalities in the detection of adverse outcomes was 100%. Transthoracic echocardiography was more specific compared to CTPA (43% vs. 28%). Statistically, flattening/bulging of the interventricular septum on TTE was significantly associated with adverse outcomes. No individual CTPA parameter was related to adverse outcomes.

Conclusion: Both CTPA and TTE are reliable imaging modalities in the detection of RVD. However, TTE is more specific, and this may help in the identification and appropriate management of patients at higher risk of decompensation. A combination of CTPA parameters rather than individual RV/LV ratios increases the sensitivity of CTPA.

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来源期刊
Anatolian Journal of Cardiology
Anatolian Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.30
自引率
7.70%
发文量
270
审稿时长
12 weeks
期刊介绍: The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
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