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01-07-2010 | Chest

Widening of coronary sinus in CT pulmonary angiography indicates right ventricular dysfunction in patients with acute pulmonary embolism

Authors: Grzegorz Staskiewicz, Elżbieta Czekajska-Chehab, Jerzy Przegalinski, Andrzej Tomaszewski, Kamil Torres, Anna Torres, Agnieszka Trojanowska, Ryszard Maciejewski, Andrzej Drop

Published in: European Radiology | Issue 7/2010

Abstract

Objectives

Right ventricular dysfunction (RVD) may occur in the course of acute pulmonary embolism (PE). Patients with RVD need more intensive treatment, and the prognosis is more severe. The aim of this study was to evaluate the usefulness of the measurement of the coronary sinus in the assessment of RVD in patients with acute PE and to compare it with other indicators of RVD.

Methods

Retrospective assessment of 55 CT pulmonary angiography examinations with signs of acute PE was performed. Pulmonary artery systolic pressure (PASP) was echocardiographically assessed in all patients, and RVD was defined as PASP values greater than 30 mmHg. CT measurements included the size of the heart ventricles, mediastinal vessels and the width of the coronary sinus.

Results

Median width of the coronary sinus was 16 mm (range 12–24 mm) in patients with increased PASP and 10 mm (range 7–22 mm) in patients with normal PASP (p = 0.001). Best cut-off value was assessed to be 12.5 mm, with sensitivity 94% and specificity 75%. It was characterised by the largest area under ROC curve (0.82) among analysed parameters.

Conclusion

Width of the coronary sinus seems to be a promising parameter for identification of RVD in patients with acute PE. A prospective study should be undertaken to further assess its clinical and prognostic applicability.

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Title: Widening of coronary sinus in CT pulmonary angiography indicates right ventricular dysfunction in patients with acute pulmonary embolism
Authors: Grzegorz Staskiewicz
Elżbieta Czekajska-Chehab
Jerzy Przegalinski
Andrzej Tomaszewski
Kamil Torres
Anna Torres
Agnieszka Trojanowska
Ryszard Maciejewski
Andrzej Drop
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 7/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1702-1

At a glance: The STEP trials

Springer Medicine

Widening of coronary sinus in CT pulmonary angiography indicates right ventricular dysfunction in patients with acute pulmonary embolism

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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