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Int J Cardiol 2018 Aug 19;265:223-228. Epub 2018 Apr 19.

Respiratory Department and Medicine Department, Ramón y Cajal Hospital, Alcalá de Henares University, IRYCIS, Madrid, Spain.

J Cardiovasc Comput Tomogr 2018 Jul - Aug;12(4):271-274. Epub 2017 Dec 2.

Departments of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx NY 10467, United States; Medicine - Division of Cardiology, Montefiore Medical Center and Albert Einstein College of Medicine, 111 E 210th St, Bronx NY 10467, United States. Electronic address:

Background: Patent foramen ovale (PFO) in patients with acute pulmonary embolism (PE) represents a risk factor for mortality, but this has not been evaluated for CT pulmonary angiography (CTPA). The purpose of the present study was to assess the relationship between PFO and mortality in patients with acute PE diagnosed on CTPA.

Materials And Methods: This retrospective study included 268 adults [173 women, mean age 61 (range 22-98) years] diagnosed with acute PE on non-ECG-gated 64-slice CTPA in 2012 at our medical center. Read More

World J Radiol 2017 Mar;9(3):143-147

Mitchell Chen, Jamal A Abdulkarim, Department of Radiology, George Eliot Hospital NHS Trust, Nuneaton, Warwickshire CV10 7DJ, United Kingdom.

Aim: To evaluate the feasibility of reducing the dose of iodinated contrast agent in computed tomography pulmonary angiography (CTPA).

Methods: One hundred and twenty-seven patients clinically suspected of having pulmonary embolism underwent spiral CTPA, out of whom fifty-seven received 75 mL and the remaining seventy a lower dose of 60 mL of contrast agent. Both doses were administered in a multiphasic injection. Read More

Am Heart J 2017 Mar 29;185:123-129. Epub 2016 Dec 29.

Respiratory Department, Ramón y Cajal Hospital and Universidad de Alcalá IRYCIS, Madrid, Spain. Electronic address:

The optimal approach to assess right ventricular (RV) function in patients with acute symptomatic pulmonary embolism (PE) lacks clarity.

Methods: This study aimed to evaluate the optimal approach to assess RV function in normotensive patients with acute symptomatic PE. Outcomes assessed through 30-days after the diagnosis of PE included all-cause mortality and complicated course. Read More

Niger J Clin Pract 2016 Nov-Dec;19(6):831-833

Department of Internal Medicine II, Clinic of Cardiology, Victor Babes University of Medicine and Pharmacy Timisoara, Timişoara, Romania.

In the last decades, an increased incidence of pulmonary embolism (PE) and acute dissection (AD) of aortic aneurysms has been registered mostly due to increased availability of advanced imaging techniques. They seldom occur concomitantly in the same patient. In this paper, we present the clinical challenges and controversies of diagnosis and therapy in a 70-year-old male patient with an atypical presentation of high-risk PE occurring concomitantly with a silent AD of a thoracic aortic aneurysm. Read More

Clinics (Sao Paulo) 2016 Oct 1;71(10):562-569. Epub 2016 Oct 1.

Tainan Municipal Hospital, Department of Internal Medicine, Tainan/Taiwan.

Objectives:: Septic pulmonary embolism is an uncommon but life-threatening disorder. However, data on patients with septic pulmonary embolism who require critical care have not been well reported. This study elucidated the clinicoradiological spectrum, causative pathogens and outcomes of septic pulmonary embolism in patients requiring critical care. Read More

J Cardiovasc Comput Tomogr 2016 Nov - Dec;10(6):473-479. Epub 2016 Aug 24.

Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, United States; Department of Radiology, The University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Background: The purpose is to develop a comprehensive risk-scoring system based on CT findings for predicting 30-day mortality after acute pulmonary embolism (PE), and to compare it with PE Severity Index (PESI).

Materials And Methods: The study included consecutive 1698 CT pulmonary angiograms (CTPA) positive for acute PE performed at a single institution (2003-2010). Two radiologists independently assessed each study regarding clinically relevant findings and then performed adjudication. Read More

Vojnosanit Pregl 2016 Sep;73(9):844-9

Background/aim: Acute pulmonary embolism (PE) is a potentially life threating event, but there are scarce data about genderrelated differences in this condition. The aim of this study was to identify gender-specific differences in clinical presentation, the diagnosis and outcome between male and female patients with PE.

Methods: We analysed the data of 144 consecutive patients with PE (50% women) and compared female and male patients regarding clinical presentation, electrocardiography (ECG) signs, basic laboratory markers and six-month outcome. Read More

J Thromb Thrombolysis 2016 Oct;42(3):432-40

China-Japan Friendship Hospital, Yinghua Dongjie, Hepingli, Beijing, 100029, People's Republic of China.

The incidence, characteristics of pleural effusions due to pulmonary thromboembolism (PTE) have been reported previously. However, the impact of pleural effusions on the prognosis of acute PTE patients and the involved influencing factors remain unclear. A total of 518 consecutive PTE patients were enrolled in Beijing Chao-Yang Hospital from January 2009 to April 2014. Read More

Int J Cardiovasc Imaging 2016 Jul 13;32(7):1153-61. Epub 2016 Apr 13.

Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

There is variability in guideline recommendations for assessment of the right ventricle (RV) with imaging as prognostic information after acute pulmonary embolism (PE). The objective of this study is to identify a clinical scenario for which normal CT-derived right-to-left ventricular (RV/LV) ratio is sufficient to exclude RV strain or PE-related short-term death. This retrospective cohort study included 579 consecutive subjects (08/2003-03/2010) diagnosed with acute PE with normal CT-RV/LV ratio (<0. Read More

J Pak Med Assoc 2016 Mar;66(3):306-11

Department of Cardiology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey.

Objective: To investigate the role of N-terminal pro-brain natriuretic peptide and apelin in the assessment of right ventricular dysfunction in acute pulmonary embolism.

Methods: The prospective case-control study was conducted at Ondokuz Mayis University, Samsun, Turkey, from January 2008 to June 2009, and comprised adult patients with acute pulmonary embolism. A smaller group of healthy adults served as the control. Read More

Med Klin Intensivmed Notfmed 2016 Mar 30;111(2):163-75; quiz 176-7. Epub 2015 Nov 30.

Medizinische Klinik II, Universitätsklinikum Gießen und Marburg, Standort Gießen, Klinikstraße 33, 35392, Gießen, Deutschland.

Pulmonary embolism is a potentially fatal disorder and frequently seen in critical care and emergency medicine. Due to a high mortality rate within the first few hours, the accurate initiation of rational diagnostic pathways in patients with suspected pulmonary embolism and timely consecutive treatment is essential. In this review, the current European guidelines on the diagnosis and therapy of acute pulmonary embolism are presented. Read More

Am J Emerg Med 2016 Feb 24;34(2):212-7. Epub 2015 Oct 24.

Department of Cardiovasology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan province, China.

Objective: Pulmonary embolism (PE) is a common cardiovascular disease that can be easily missed or misdiagnosed. Electrocardiogram (ECG) is valuable in making early diagnoses and performing risk stratification with regard to acute PE.

Methods: A total of 147 hospitalized patients diagnosed with acute PE were enrolled in this study and divided into the following 2 groups: main pulmonary artery trunk or main pulmonary artery (MPA) embolism and lobar artery or remote branch embolism. Read More

Presse Med 2015 Dec 14;44(12 Pt 2):e385-91. Epub 2015 Nov 14.

University of Ottawa, Ottawa hospital research institute, department of medicine, Ottawa, Canada; Université de Brest, department of internal medicine, EA 3878, CIC 1412, 29609 Brest, France.

Pulmonary embolism is the third cause of mortality by cardiovascular disease after coronary artery disease and stroke, and its incidence is around 1/1000 per year. During the last two decades, many different non-invasive diagnostic tests have been developed and validated. For hemodynamically stable outpatients, the diagnosis of acute pulmonary embolism mainly rests on the sequential use of clinical assessment, D-dimer measurement and multidetector CT. Read More

Clin Radiol 2015 Dec 15;70(12):1370-5. Epub 2015 Sep 15.

Dept. of Radiology, Royal Infirmary of Edinburgh, UK.

Aim: To examine the number and nature of investigations performed for suspected pulmonary embolism (PE) in a large teaching hospital and the change in incidence and severity of PE over a decade.

Materials And Methods: In this retrospective study, all patients investigated for suspected PE using computed tomography pulmonary angiography (CTPA) or lung scintigraphy during 10 years to March 2012 were identified and their records reviewed. In the final year, all reportedly positive CTPA cases were reviewed and PE severity calculated, for comparison with similar historical data. Read More

J Cardiovasc Comput Tomogr 2015 Nov-Dec;9(6):524-33. Epub 2015 Aug 3.

Imaging Institute and Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address:

Background: Prompt diagnosis and early referral to specialized centers is critical for patients presenting with cardiovascular emergencies, including acute aortic syndromes (AAS). Prior data has suggested that mobile access to imaging studies with hand-held devices can accelerate diagnosis and management.

Objective: We conducted a study to determine the diagnostic accuracy of a hand-held device compared to conventional dedicated work-stations for diagnosing a spectrum of cardiovascular emergencies, predominantly acute aortic pathology. Read More

J Thromb Haemost 2015 Sep 11;13(9):1623-34. Epub 2015 Aug 11.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Background: With ongoing technical developments, magnetic resonance imaging (MRI) has notably evolved for the assessment of the pulmonary vasculature. However, uncertainty persists about the performance of MRI for the diagnosis of acute pulmonary embolism (APE).

Objectives: To clarify the comprehensive role of MRI in diagnosing APE. Read More

Int J Cardiovasc Imaging 2015 Dec 2;31 Suppl 2:125-43. Epub 2015 Jul 2.

Department of Medicine (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, 246 Clayton Road, Clayton, Melbourne, 3168, Australia.

Chest pain is one of the most common presenting symptoms leading to presentation to medical clinics and Emergency Departments worldwide. Defining the nature and etiology of chest pain can pose a diagnostic dilemma for clinicians, despite the availability of several diagnostic algorithms and guidelines to assist them in evaluating these patients. Most investigations in patients with acute chest pain are initially performed to either exclude or diagnose and manage potentially life-threatening conditions such as acute coronary syndrome, pulmonary embolism and aortic dissection. Read More

Hippokratia 2014 Oct-Dec;18(4):333-9

Department of Pulmonary Medicine, Faculty of Medicine, 19 Mayis University, Samsun, Turkey.

Aim: This study investigated the utility of the alveolar-arterial (AaDO2) gradient in predicting the short-term prognosis of submassive pulmonary embolism (PE).

Material And Methods: This study retrospectively enrolled 124 patients with acute submassive PE. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Read More

Clin Chest Med 2015 Jun 26;36(2):235-48, viii. Epub 2015 Mar 26.

Cardiothoracic Imaging, Mallinckrodt Institute of Radiology, Washington University School of Medicine in St Louis, 510 South Kingshighway Boulevard, Box 8131, St Louis, MO 63110, USA. Electronic address:

Pulmonary vascular diseases encompass a large and diverse group of underlying pathologies ranging from venous thromboembolism to congenital malformations to inflammatory vasculitides. As a result, patients can present either acutely with dyspnea and chest pain or chronically with dyspnea on exertion, hypoxia, and right heart failure. Imaging, particularly with multidetector CT, plays a key role in the evaluation and management of patients with suspected pulmonary vascular disease and, given the widespread routine use of high-quality CT pulmonary angiography, it is imperative that radiologists be familiar these pathologies. Read More

Thromb Haemost 2015 Jul 28;114(1):26-34. Epub 2015 May 28.

P. L. den Exter, MD, Department of Thrombosis and Hemostasis, Leiden University Medical Center, Albinusdreef 2, P.O Box 9600, 2300 RC, Leiden, the Netherlands, Tel: + 31 71 526 2085; Fax: +31 71 524 8140, E-mail:

The systematic assessment of residual thromboembolic obstruction after treatment for acute pulmonary embolism (PE) has been understudied. This assessment is of potential clinical importance, should clinically suspected recurrent PE occur, or as tool for risk stratification of cardiopulmonary complications or recurrent venous thromboembolism (VTE). This study aimed to assess the rate of PE resolution and its implications for clinical outcome. Read More

Pulm Circ 2015 Mar;5(1):171-83

Division of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA; and Eskenazi Health Center, Indianapolis, Indiana, USA.

Many dyspneic patients who undergo computerized tomographic pulmonary angiography (CTPA) for presumed acute pulmonary embolism (PE) have no identified cause for their dyspnea yet have persistent symptoms, leading to more CTPA scanning. Right ventricular (RV) dysfunction or overload can signal treatable causes of dyspnea. We report the rate of isolated RV dysfunction or overload after negative CTPA and derive a clinical decision rule (CDR). Read More

Abdom Imaging 2015 Oct;40(7):2883-93

The Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins School of Medicine, 601 N. Caroline Street, Baltimore, MD, 21287, USA.

Patients who have unenhanced abdominal CT scans are often critically ill. The unenhanced CT may reveal many unsuspected subtle abnormalities in the lower chest, abdomen, and pelvis and accordingly warrants careful attention. This article reviews unenhanced CT findings in the setting of pulmonary embolus, acute aortic syndromes, mesenteric and deep venous thrombosis, gastrointestinal hemorrhage, pancreatitis and its complications, as well as pyelonephritis. Read More

Pediatr Radiol 2015 Sep 7;45(10):1431-9. Epub 2015 Apr 7.

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China.

Pulmonary embolism is a life-threatening condition affecting people of all ages. Multidetector row CT pulmonary angiography has improved the imaging of pulmonary embolism in both adults and children and is now regarded as the routine modality for detection of pulmonary embolism. Advanced CT pulmonary angiography techniques developed in recent years, such as dual-energy CT, have been applied as a one-stop modality for pulmonary embolism diagnosis in children, as they can simultaneously provide anatomical and functional information. Read More

Eur Radiol 2015 Sep 13;25(9):2547-57. Epub 2015 Mar 13.

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China,

Multidetector computed tomography (CT) plays an important role in the detection, risk stratification and prognosis evaluation of acute pulmonary embolism. This review will discuss the technical improvements for imaging peripheral pulmonary arteries, the methods of assessing pulmonary embolism severity based on CT findings, a multidetector CT technique for pulmonary embolism detection, and lastly, how to avoid overutilization of CT pulmonary angiography and overdiagnosis of pulmonary embolism. Key Points • We describe clinical prediction rules and D-dimers for pulmonary embolism evaluation. Read More

Acad Radiol 2015 Jun 13;22(6):743-51. Epub 2015 Mar 13.

Medical Imaging Center, Department of Radiology, The First Affiliated Hospital, Jinan University, No. 613 West Huangpu Ave, Tianhe District, Guangzhou 510630, China. Electronic address:

Rationale And Objectives: To assess the diagnostic value of dual-energy (DE) computed tomography pulmonary angiography (CTPA) for acute pulmonary embolism (PE) using a helical DE scan mode with rapid kVp switching.

Materials And Methods: Seventy-six patients with suspected acute PE underwent DE CTPA. Two readers independently assessed and measured the iodine maps. Read More

Angiol Sosud Khir 2015 ;21(1):25-8

Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin under the RF Public Health Ministry, Novosibirsk, Russia.

The article provides a detailed description of a clinical case report of acute massive pulmonary artery thromboembolism (PATE) in an elderly female patient. She was diagnosed with a carrier state of polymorphism of genes associated with impairment in the folate cycle MTHFR:677 - TT, MTRR:66 - AG and polymorphisms associated with disordered blood coagulation system F13 - GT; ITGB3:1565 - TC; SERPINE1 (PAI-1):675 - 4G4G. She was also found to have hyperhomocysteinemia - 67. Read More

Kaohsiung J Med Sci 2015 Mar 16;31(3):145-9. Epub 2015 Jan 16.

Department of Cardiology, Mersin University School of Medicine, Mersin, Turkey.

The purpose of this study was to determine the role of red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in the diagnostic phase of acute pulmonary embolism (PE). We screened 248 consecutive patients who were admitted to the emergency service with PE foremost in the differential diagnosis. Based on spiral computed chest tomography, the patients were divided into two groups. Read More

Am J Med 2015 Jul 11;128(7):747-59.e2. Epub 2015 Feb 11.

Department of Radiology, University of Tübingen, Tübingen, Germany.

Background: Many computed tomography (CT) parameters have been proposed as potential predictors of outcome in acute pulmonary embolism. We sought to summarize available evidence on the predictive value of CT severity parameters for short-term clinical outcome in pulmonary embolism.

Methods: We searched PubMed and EMBASE through February 2014 for studies that reported on the association between CT parameters of acute pulmonary embolism severity and short-term (≤6 months) clinical outcome. Read More

J Card Surg 2015 Apr 30;30(4):301-6. Epub 2015 Jan 30.

Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan.

Background And Aim: Clinically unsuspected pulmonary embolism can be detected using coronary computed tomography (CT), but the clinical significance of unsuspected pulmonary embolism remains unclear.

Methods: Pulmonary embolism was assessed using consecutive coronary CT from March 2003 to June 2007 to assess 1077 patients. Coronary CT was performed using a 16-row multidetector CT (MDCT) scanner with ECG-gating. Read More

Dtsch Med Wochenschr 2015 Jan 22;140(2):89-96. Epub 2015 Jan 22.

Universitätsklinikum Hamburg-Eppendorf.

Acute pulmonary embolism is an important differential diagnosis of acute chest pain. The clinical signs are often non-specific. However, diagnosis and therapy must be done quickly in order to reduce morbidity and mortality. Read More

Cytotherapy 2015 Apr 15;17(4):392-402. Epub 2015 Jan 15.

Department of Anatomy and Cell Biology, Medical Research Center, University of Oulu, Oulu, Finland.

Background Aims: Bone marrow mononuclear cells (BM-MNCs) and bone marrow-derived mesenchymal stem stromal cells (BM-MSCs) could have therapeutic potential for numerous conditions, including ischemia-related injury. Cells transplanted intravascularly may become entrapped in the lungs, which potentially decreases their therapeutic effect and increases the risk for embolism.

Methods: Twelve pigs were divided into groups of 3 and received (99m)Tc- hydroxymethyl-propylene-amine-oxime-labeled autologous BM-MNCs or allogeneic BM-MSCs by either intravenous (IV) or intra-arterial (IA) transplantation. Read More

Emerg Radiol 2015 Aug 9;22(4):379-84. Epub 2015 Jan 9.

Department of Radiology, NYU Langone Medical Center, 660 1st Avenue, 3rd Floor, New York, NY, 10016, USA,

To compare utilization of CT pulmonary angiogram (CTA) for diagnosis of pulmonary embolism (PE) in an emergency department (ED) with unstructured CT ordering to published rates of CT positivity in other EDs including those employing decision support and to identify pathways for improved utilization via collaboration with our pathology and ED colleagues. Two hundred seventeen patients over a 2.5-month time period who received a CTA for PE were reviewed with exclusion of pediatric patients and all sub-optimal, non-diagnostic, or equivocal scans; 21 were excluded leaving a sample of 196 patients. Read More

Int J Cardiovasc Imaging 2015 Mar 27;31(3):509-15. Epub 2014 Nov 27.

Echocardiography Laboratory - MDP, Hospital Israelita Albert Einstein, São Paulo, Brazil,

The impact of pulmonary embolism on right ventricular (RV) performance can be evaluated by echocardiography, however, the relationship between pulmonary vascular involvement and RV burden is controversial. To assess the effect of clot burden on RV performance we studied 85 patients (aged 53 ± 17 years, 39 female) with confirmed PE by multislice computed tomography (CT) and echocardiography within 24 h of diagnosis. A CT score ranging from 1 to 20 points according to the pulmonary arteries involved was used. Read More

Eur Rev Med Pharmacol Sci 2014 ;18(17):2551-5

Department of Respiratory Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu Province, China. yyd1108

Objective: We tested whether correlation between embolism area and pulmonary arterial pressure may serve as an indicator of pulmonary arterial hypertension in patients with acute pulmonary thromboembolism.

Patients And Methods: In total, 204 patients who underwent spiral computed tomography (CT) pulmonary angiography and ultrasonic cardiogram were enrolled. The patients were stratified according to their pulmonary arterial systolic pressure into those with normal values, or those with mild, moderate, or severe pulmonary arterial hypertension. Read More

Eur Radiol 2015 Jan 28;25(1):147-54. Epub 2014 Aug 28.

Department of Radiology, Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

Objective: To investigate the prognostic validity of the right ventricular to left ventricular diameter (RVD/LVD) ratio and Qanadli pulmonary artery obstruction score (PAOS) in hemodynamically stable patients with no pre-existing comorbidities.

Methods: Sixty-three patients with no previous comorbidity were recruited for this study. The RVD/LVD ratio was calculated based on axial image measurements obtained from contrast-enhanced non-electrocardiography-gated spiral computed tomography (CT) pulmonary angiographic studies. Read More

J Thromb Haemost 2014 Oct 26;12(10):1658-66. Epub 2014 Sep 26.

Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.

Background: Hydration to prevent contrast-induced acute kidney injury (CI-AKI) induces a diagnostic delay when performing computed tomography-pulmonary angiography (CTPA) in patients suspected of having acute pulmonary embolism.

Aim: To analyze whether withholding hydration is non-inferior to sodium bicarbonate hydration before CTPA in patients with chronic kidney disease (CKD).

Methods: We performed an open-label multicenter randomized trial between 2009 and 2013. Read More

Int J Cardiovasc Imaging 2014 Dec 6;30 Suppl 2:113-20. Epub 2014 Aug 6.

Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.

The purpose of this study was to prospectively evaluate the diagnostic capability of single-phase dual-energy CT (DECT) angiography to differentiate acute and chronic pulmonary thromboembolism (APTE, CPTE). We prospectively enrolled 26 patients (M:F = 9:17; mean age, 61 years old) with a filling defect in the pulmonary artery on DECT angiography. They were divided into two groups-APTE and CPTE-based on the clinical criteria. Read More

Adv Clin Exp Med 2014 May-Jun;23(3):371-6

Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland.

Background: Acute pulmonary embolism (APE), despite improvements in diagnostic methods, often remains undiagnosed. Recently, systolic dysfunction has also been described as assessed by new echocardiographic techniques, such as tissue Doppler imaging (TDI).

Objectives: In our study we have attempted to assess diastolic function within the mitral and tricuspid annuli in congestive heart failure (CHF) patients with coexisting APE. Read More

COPD 2015 Feb 10;12(1):38-45. Epub 2014 Jun 10.

1Department of Radiology (MH, PAG), Hôpital Erasme, Université libre de Bruxelles , Brussels , Belgium.

Unlabelled: Abstract Objective: To describe CT features associated with severe exacerbations of Chronic Obstructive Pulmonary Disease (COPD).

Materials And Methods: In this prospective ethical-committee-approved study, 44 COPD patients (34 men, 10 women, age range 49-83 years) who provided written informed consent were included at the time of hospital admission for severe exacerbation. Pulmonary function tests (PFT) and chest CT scans were performed at admission and after resolution of the episode following a minimum of 4 weeks free of any acute symptom. Read More

Thromb Haemost 2014 Sep 5;112(3):598-605. Epub 2014 Jun 5.

Olivier Sanchez, MD, PhD, Service de pneumologie et de soins intensifs, Hôpital européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France, Tel.: +33 1 56 09 34 61, Fax: +33 1 56 09 32 55, E-mail:

Chronic thromboembolic pulmonary hypertension (CTEPH) has been estimated to occur in 0.1-0.5% of patients who survive a pulmonary embolism (PE), but more recent prospective studies suggest that its incidence may be much higher. Read More

Jpn J Radiol 2014 Aug 13;32(8):451-60. Epub 2014 May 13.

Department of Cardiology, Necmettin Erbakan University Meram School of Medicine Hospital, Meram, 42080, Konya, Turkey,

Purpose: To evaluate the accuracy of cardiac computed tomography (CT) parameters and pulmonary artery (PA) obstruction (OS) scores in determining the echocardiographic right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (PE).

Materials And Methods: A total of 120 patients with acute PE were included in the study. Right ventricle/left ventricle ratio (RV/LV); PA axial diameter; superior vena cava (SVC) axial diameter; and Ghanima, Miller, Qanadli, and Mastora obstruction scores were obtained using CT. Read More

Int J Cardiovasc Imaging 2014 Jun 29;30 Suppl 1:25-32. Epub 2014 Apr 29.

Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.

A left-bulging atrial septum (AS) is an abnormal sign indicating hemodynamic overloading of the right heart. We tried to evaluate whether computed tomography (CT)-derived AS bulging and ventricular septum (VS) bowing signs would be used to identify patients with acute pulmonary embolism (PE) and significant hemodynamic derangements. In the prospective registry, 208 consecutive patients with a first episode of acute PE diagnosed by chest CT were grouped by clinical hemodynamic assessment: massive or submassive PE (Group 1), and small PE (Group 2). Read More

Rofo 2014 Aug 22;186(8):751-61. Epub 2014 Apr 22.

Department of Radiology, Universitätsmedizin Mainz.

Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension (resting mean pulmonary arterial pressure of 25 mm Hg or more determined at right heart catheterization) with persistent pulmonary perfusion defects. It is a rare, but underdiagnosed disease with estimated incidences ranging from 0.5% to 3. Read More

Arch Med Sci 2014 Feb 23;10(1):39-46. Epub 2014 Feb 23.

Department of Internal Medicine and Cardiology, Warsaw Medical University, Warsaw, Poland.

Introduction: The diagnosis of acute pulmonary embolism (APE) in patients with chronic heart failure (CHF) remains a difficult task, despite the refinement of imaging techniques. The goal of this study was to assess the value of measuring tricuspid and mitral valve systolic annular velocities in CHF patients with suspected PE by tissue Doppler imaging (TDI).

Material And Methods: The study included 75 patients with previously diagnosed CHF, admitted due to resting dyspnea, with a maximum tricuspid regurgitation pressure gradient (TRPG) of ≥ 35 mm Hg and positive D-dimer assay. Read More

Acta Cardiol 2014 Feb;69(1):23-8

Objective: Patients with acute pulmonary thromboembolism (PTE) and right ventricular (RV) dysfunction may benefit from thrombolytic therapy. We sought to determine the usefulness of RV strain imaging in the demonstration of improvement in RV function in response to thrombolytic therapy.

Methods: This study prospectively enrolled 32 consecutive patients who received thrombolytic therapy due to diagnosis of PTE. Read More

Acute Card Care 2014 Jun 12;16(2):63-6. Epub 2014 Mar 12.

Internal Medicine Service, Centro Hospitalar Barreiro-Montijo, EPE , Lisbon , Portugal.

Introduction: There is considerable debate regarding the use of thrombolytic therapy in patients with pulmonary embolism, normal blood pressure and intermediate clinical risk, as defined by right ventricular dysfunction on transthoracic echocardiography or elevated serum markers of cardiac necrosis.

Aims And Objectives: A clinical audit of normotensive patients diagnosed with acute pulmonary embolism using multi- detector computerized tomography pulmonary angiography (MDCTPA) and intermediate risk, was conducted to determine clinical outcomes at 30 days. The specific role played by imaging findings and clinical severity, on the decision to thrombolyse, was assessed. Read More

Clin Respir J 2015 Jul 15;9(3):270-7. Epub 2014 Apr 15.

Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisie.

Purpose: We aimed to determine the incidence and the prognostic impact [mortality and length of intensive care unit (ICU) stay (LOS)] of pulmonary embolism (PE) in critically ill patients with severe acute exacerbation of chronic obstructive pulmonary disease (COPD).

Methods: This is a retrospective study performed during a 5-year period in the ICU of Habib Bourguiba University Hospital (Sfax, Tunisia). All patients with severe acute exacerbation of COPD were included. Read More

Am J Respir Crit Care Med 2014 Mar;189(6):718-26

1 Respiratory Department, Ramón y Cajal Hospital, IRYCIS, Madrid, Spain.

Rationale: Not all patients with acute pulmonary embolism (PE) have a high risk of an adverse short-term outcome.

Objectives: This prospective cohort study aimed to develop a multimarker prognostic model that accurately classifies normotensive patients with PE into low and high categories of risk of adverse medical outcomes.

Methods: The study enrolled 848 outpatients from the PROTECT (PROgnosTic valuE of Computed Tomography) study (derivation cohort) and 529 patients from the Prognostic Factors for Pulmonary Embolism (PREP) study (validation cohort). Read More

J Emerg Med 2014 Apr 22;46(4):465-71. Epub 2014 Jan 22.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: There is limited information on the extent and clinical importance of the delay in hospital presentation of acute pulmonary thromboembolism (PTE).

Objective: The aim of this study was to investigate the delay in hospital presentation of PTE and its association with clinical and imaging findings in PTE.

Methods: This prospective study was conducted on patients admitted to our hospital with a diagnosis of acute PTE between September 2007 and September 2011. Read More