Application of CT pulmonary angiography in acute pulmonary embolism and right heart function

ZHANG Hongxia; CONG Xinying; ZHANG Tian; WU Ye; LI Qing; LI Xuejing; CHEN Yifan; WANG Xiuting; YU Weiyong; CHEN Zhenbo

doi:10.3969/j.issn.1006-9771.2023.12.007

Abstract：Objective To explore the application value of CT pulmonary angiography(CTPA)in assessing the severity of acute pul-monary embolism(APE)and right heart function in rehabilitation patients. Methods From January,2013 to January,2020,133 inpatients(94 positive and 39 negative)who underwent CTPA exam-ination in Beijing Bo'ai Hospital were involved.Positive patients were further divided into mild,moderate and se-vere groups based on the pulmonary artery obstruction index(PAOI).The clinical parameters and right heart function indicators were compared.Spearman correlation analysis was used to analyze the correlation between PAOI,and clinical parameters and right heart function indicators,and Logistic regression analysis was used to predict the risk factors of APE. Results There was significant difference in lower extremity venous thrombosis,D-dimer,oxygen partial pressure,PAOI and left process of interventricular septum among four groups(H≥12.350,P<0.01).PAOI was moderately pos-itively correlated with D-dimer(r = 0.443,P<0.001)and left process of interventricular septum(r = 0.520,P<0.001),and was weakly positively correlated with lower extremity venous thrombosis(r = 0.399,P<0.001),left pulmonary artery diameter(r = 0.213,P = 0.014)and inferior vena cava regurgitation(r = 0.229,P = 0.008).Lower extremity venous thrombosis(OR = 7.708,P<0.001)and left process of interventricular septum(OR = 3.641,P = 0.008)were independent risk factors for the onset of APE.The combination of the two indicators was effective for diagnosis of APE,and AUC was 0.795(95%CI 0.715 to 0.874). Conclusion CTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.