PT  - JOURNAL ARTICLE
AU  - David Jiménez
AU  - José Luis Lobo
AU  - Manuel Monreal
AU  - Lisa Moores
AU  - Mikel Oribe
AU  - Manuel Barrón
AU  - Remedios Otero
AU  - Dolores Nauffal
AU  - Ramón Rabuñal
AU  - Reina Valle
AU  - Carmen Navarro
AU  - Consolación Rodríguez-Matute
AU  - Celso Álvarez
AU  - Francisco Conget
AU  - Fernando Uresandi
AU  - Drahomir A Aujesky
AU  - Roger D Yusen
AU  - on behalf of the PROTECT investigators
TI  - Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: results of the protect study
AID  - 10.1136/thoraxjnl-2012-202900
DP  - 2014 Feb 01
TA  - Thorax
PG  - 109--115
VI  - 69
IP  - 2
4099  - http://thorax.bmj.com/content/69/2/109.short
4100  - http://thorax.bmj.com/content/69/2/109.full
SO  - Thorax2014 Feb 01; 69
AB  - Background In patients with acute pulmonary embolism (PE), rapid and accurate risk assessment is paramount in selecting the appropriate treatment strategy. The prognostic value of right ventricular dysfunction (RVD) assessed by multidetector CT (MDCT) in normotensive patients with PE has lacked adequate validation. Methods The study defined MDCT-assessed RVD as a ratio of the RV to the left ventricle short axis diameter greater than 0.9. Outcomes assessed through 30 days after the diagnosis of PE included all-cause mortality and ‘complicated course’, which consisted of death from any cause, haemodynamic collapse or recurrent PE. Results MDCT detected RVD in 533 (63%) of the 848 enrolled patients. Those with RVD on MDCT more frequently had echocardiographic RVD (31%) than those without RVD on MDCT (9.2%) (p<0.001). Patients with RVD on MDCT had significantly higher brain natriuretic peptide (269±447 vs 180±457 pg/ml, p<0.001) and troponin (0.10±0.43 vs 0.03±0.24 ng/ml, p=0.001) levels in comparison with those without RVD on MDCT. During follow-up, death occurred in 25 patients with and in 13 patients without RVD on MDCT (4.7% vs 4.3%; p=0.93). Those with and those without RVD on MDCT had a similar frequency of complicated course (3.9% vs 2.3%; p=0.30). Conclusions The PROgnosTic valuE of CT study showed a relationship between RVD assessed by MDCT and other markers of cardiac dysfunction around the time of PE diagnosis, but did not demonstrate an association between MDCT–RVD and prognosis.