Adjusting Atrial Size Parameters for Body Surface Area: Does it Affect the Association With Pulmonary Embolism-related Adverse Events?

Autor:	Kirkbride RR; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Aviram G; Department of Cardiothoracic Imaging, Tel-Aviv Medical Center, Tel-Aviv University, Israel., Heidinger BH; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria., Liberman Y; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Libauske A; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Liubauskas R; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Tridente DM; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Brook A; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., DaBreo DC; Department of Radiology, Cardiothoracic Radiology, Queen's University, Kingston, Ontario, Canada., Monteiro Filho AC; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Carroll BJ; Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Matos JD; Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., McCormick IC; Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Manning WJ; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.; Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Litmanovich DE; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of thoracic imaging [J Thorac Imaging] 2024 Jul 01; Vol. 39 (4), pp. 208-216. Date of Electronic Publication: 2024 Apr 18.
DOI:	10.1097/RTI.0000000000000781
Abstrakt:	Purpose: Small left atrial (LA) volume was recently reported to be one of the best predictors of acute pulmonary embolism (PE)-related adverse events (AE). There is currently no data available regarding the impact that body surface area (BSA)-indexing of atrial measurements has on the association with PE-related adverse events. Our aim is to assess the impact of indexing atrial measurements to BSA on the association between computed tomography (CT) atrial measurements and AE. Materials and Methods: Retrospective study (IRB: 2015P000425). A database of hospitalized patients with acute PE diagnosed on CT pulmonary angiography (CTPA) between May 2007 and December 2014 was reviewed. Right and left atrial volume, largest axial area, and axial diameters were measured. Patients undergo both echocardiographies (from which the BSA was extracted) and CTPAs within 48 hours of the procedure. The patient's body weight was measured during each admission. LA measurements were correlated to AE (defined as the need for advanced therapy or PE-related mortality at 30 days) before and after indexing for BSA. The area under the ROC curve was calculated to determine the predictive value of the atrial measurements in predicting AE. Results: The study included 490 acute PE patients; 62 (12.7%) had AE. There was a significant association of reduced BSA-indexed and non-indexed LA volume (both <0.001), area (<0.001 and 0.001, respectively), and short-axis diameters (both <0.001), and their respective RA/LA ratios (all <0.001) with AE. The AUC values were similar for BSA-indexed and non-indexed LA volume, diameters, and area with LA volume measurements being the best predictor of adverse outcomes (BSA-indexed AUC=0.68 and non-indexed AUC=0.66), followed by non-indexed LA short-axis diameter (indexed AUC=0.65, non-indexed AUC=0.64), and LA area (indexed AUC=0.64, non-indexed AUC=0.63). Conclusion: Adjusting for BSA does not substantially affect the predictive ability of atrial measurements on 30-day PE-related adverse events, and therefore, this adjustment is not necessary in clinical practice. While LA volume is the better predictor of AE, LA short-axis diameter has a similar predictive value and is more practical to perform clinically. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu