Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism

J Comput Assist Tomogr. 2021 Nov-Dec;45(6):863-869. doi: 10.1097/RCT.0000000000001199.

Abstract

Objective: To assess coronary artery calcification (CAC) in patients with acute pulmonary embolism and determine whether this correlates with right ventricular dilation (RVD) and mortality.

Methods: Computed tomography pulmonary angiography scans of 330 patients were used to perform retrospective assessment of the pulmonary artery computed tomography obstruction index (PACTOI), the right/left ventricle diameter ratio, the diameter of the pulmonary trunk, and the ordinal CAC score.

Results: Age (P < 0.001), urea level (P < 0.001), D-dimer level (P = 0.006), diameter of the pulmonary trunk (P < 0.001), and PACTOI (P < 0.001) were significantly higher in the RVD-positive patient group. We found a significant relation between increased CAC score and increased mortality (P = 0.038). Left-sided CAC was detected much more often in RVD-positive patients (P = 0.008).

Conclusions: Coronary artery calcification is common in patients with acute pulmonary embolism, especially when those patients are also RVD-positive. A significant relation was found between RVD and left-sided CAC.

MeSH terms

  • Acute Disease
  • Aged
  • Computed Tomography Angiography / methods*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Female
  • Heart Ventricles / pathology
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / pathology
  • Retrospective Studies
  • Vascular Calcification / complications
  • Vascular Calcification / diagnostic imaging*
  • Vascular Calcification / pathology
  • Ventricular Dysfunction, Right / complications*
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / pathology