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Expression of tissue factor in rabbit pulmonary artery in an acute pulmonary embolism model

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World Journal of Emergency Medicine 2014年第2期5卷 144-147页

作者： Jing-xia Zhang Yong-li Chen Yu-ling Zhou Qian-yu Guo Xian-pei Wang Department of Cardiology Tianjin Chest Hospital

BACKGROUND: Tissue factor(TF) is the initiation factor of the extrinsic coagulation pathway, and plays a critical role in the process of thrombosis. This study aimed to investigate the expression of TF and to explore their clinical effect on the pulmonary artery after acute pulmonary thromboembolism.METHODS: Thirty-four Japanese white rabbits(Level II animals) supplied by Tianjin Medical University were randomly assigned into: group A, specimens of the pulmonary artery taken 3 hours after pulmonary embolism(n=8); group B, specimens of the pulmonary artery taken 8 hours after pulmonary embolism(n=8); group C, specimens of the pulmonary artery taken 24 hours after pulmonary embolism(n=8); and control group, pseudo-operations performed without injection of autologous blood clots(n=10). The animal model of pulmonary thrombo-embolism was established by injection of autologous blood clots into the jugular vein through a 5F catheter, and was conf irmed by digital subtraction angiography. The mRNA expression of TF in different parts of the pulmonary artery was accessed by RT-PCR. The q test was used if there was a signif icant difference in a given continuous variable among the three groups assessed by ANOVA. The experiment equipment was supplied by the State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, the Chinese Academy of Medical Sciences and Peking Union Medical College.RESULTS: The TF expression in the specimen adjacent to emboli was stable at 3, 8 or 24 hours after embolism. The mRNA expression of TF at 3 and 8 hours after embolism was lower in the specimens taken from the distal end of the morbid pulmonary artery than those adjacent to emboli. While at 24 hours after embolism, there were similar mRNA levels in specimens either adjacent or distal to emboli.CONCLUSION: The high level of TF expression in pulmonary artery tissue adjacent to emboli could lead to locally increased coagulation activity, indicating the necessity of initiating anticoagulation treatment as

关键词： pulmonary embolism Tissue factor pulmonary Gene expression Thrombus Anticoagulation Thrombolysis Rabbits

Contribution of Diagnosis Examinations in pulmonary embolism

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World Journal of Cardiovascular Diseases 2021年第12期11卷 564-571页

作者： Machihude Pio Doguessaga Borgiata Atta Yaovi Mignazonzon Afassinou Soulemane Pessinaba Hamza Doles Sama Tchaa Tchérou Ablavi Ena Todo-Alipui Wiyaou Dieudonnné Kaziga Abalo Mario Bakai Soodougoua Baragou Findibé Damorou Cardiology Department Kara Unviversity Hospital Kara Togo Cardiology Department Sokode Hospital Togo Cardiology Department Sylvanus Olympio University Hospital Lomé Togo Cardiology Department Campus University Hospital Lomé Togo

Background: We aimed to determine the specificities of pulmonary embolism (PE) investigations and their statistical link according to PE’s degrees of severity. Patients and Methods: It was a cross-sectional study on patient- records admitted in Cardiology Department for PE, from June 1st 2014 to April 30th 2019. We studied electrocardiogram (ECG), Chest X-ray, Echocardiographic, D-dimers, CT pulmonary angiographic (CTPA) data. PE diagnosis was retained at the CTPA. PE was classified according to its severity (low, intermediate, and severe). Patients were arbitrarily categorized in 4 groups (G1 - G4) according to D-dimer level. Results: We retained 110 patient- records of patients mean aged 56 ± 15 years, with female predominance (Sex-ratio F/M = 1.82). Patients with main pulmonary artery’s (MPA) embolism had D-dimer value > 5000 ng/mL. The more proximal embolism was located, the higher D-dimer level was, but no significant association was found between D-dimer level and PE’s severity. CTPA showed bilateral location of embolism in 52% of cases. Severe PE (SPE) was significantly associated to proximal location (main and segmental branches of PA), and repolarization disorders. S1Q3 aspect was associated to intermediate mortality risk PE. On chest X-ray, cardiomegaly and the left middle arch conve

关键词： pulmonary embolism D-Dimer Severity Diagnosis Togo

Diagnostic Evaluation of pulmonary embolism: A Computerized Tomography Based Study

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Open Journal of Radiology 2016年第3期6卷 157-167页

作者： Salah Eldein Hassan Aloub Caroline Edward Ayad College of Medical Radiological Science Sudan University of Science and Technology Khartoum Sudan

pulmonary embolism (PE) is potentially life threatening condition which requires adequate diagnosis. Since computerized tomography pulmonary angiography (CTPA) described the presence of a clot subjectively, an objective and quantification method to characterize plural parenchymal abnormality, pulmonary vessels and heart is needed (in order to diagnose PE). This study was directed to investigate whether the presence of plural parenchymal findings correlates with the PE and as well, it was designed to answer two basic questions based on CTPA findings done for clinical suspicion of PE: firstly, what are the plural parenchymal abnormalities associated with PE;secondly, correlation of PE with the presence of heart changes and pulmonary vessels measurements. CTPA scans were acquired for 55 patients suspected of having PE and another 50 subjects who were considered as control. The clinical signs and pleuroparenchymal abnormalities, pulmonary artery tree measurements, right ventricle and atrium diameters, Inter ventricular septum width as well as the myocardium thickening were characterized and correlated with PE. The results showed that the PE patients group has more dilated measurements than the normal control subjects. The right ventricle diameter changes were found to be significantly related to the presence of PE at p ≤ 0.001. Significant changes at p ≤ 0.005 were also noticed in the pulmonary trunk diameter as well as the right and left main pulmonary arteries with no significant changes detected in the distal portion of both pulmonary arteries diameters. The common complaints from PE patients were chest pain, shortness of breathing, lower limb swelling, tachycardia and syncope. Consolidation, ground glass opacifications, mosaic, right ventricle morphological changes and pleural effusion were present in the majority of patients undergoing CTPA for the clinical suspicion of PE. CTPA is considered as the diagnostic modality of choice in characterization of pulmonary vessels, atrium and ventricle changes as well as pl

关键词： pulmonary embolism Computerized Tomography pulmonary Angiography Pleuroparenchymal Abnormalities

Epidemio-Clinical, Therapeutic and Evolutive Aspects of pulmonary embolism in Young Subject in the Cardiology Department in Point “G” Hospital University Center Bamako

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Open Journal of Epidemiology 2020年第4期10卷 393-398页

作者： M. Sako S. Sidibé M. Konaté B. Sonfo N. Diallo M. Diakité C. Thiam A. Keita I. Sangaré H. O. Ba Y. Camara L. Bouaré Y. R. Koumaré S. Coulibaly I. Minta Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital MALI Bamako Mali Cardiology Department Hospital KATI Bamako Mali Cardiology Department Hospital LUXEMBOURG Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali

Objective: The purpose of this work was to determine the epidemiological, clinical and evolutionary aspects of the pulmonary embolism of the young person in the cardiology department of the University Hospital Center (CHU) Point G in Bamako-Mali. Methodology: This was an analytical study from January 01, 2018 to December 31, 2018 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 1379 hospitalized patients, 19 patients were concerned by pulmonary embolism of the young person. The prevalence of pulmonary embolism of the young person was 1.37%. The most affected age group was 21 - 30 (47.4%) of patients. The predominance was female (89.47%) with a gender ratio of 0.11 in favour of women. The average age in the series was 29.79 years with extremes of 16 years and 40 years. Factors predisposing to pulmonary embolism were dominated by peri partum, cardiomyopathy and obesity with 47.3%, 31.57% and 21.1%, respectively. The dominant signs were chest pain and dyspnea in 94.7% and 89.5% of cases respectively. pulmonary embolism was unlikely in 60.52% according to the Geneva and Wells score simplified. At the thoracic angioscanner, the embolism was bilateral in 52.6% of cases and distal in 36.8% of patients;in 10 patients who performed cardiac ultrasound, pulmonary arterial hypertension (70%), dilation of the right ventricle (20%) and left ventricular dilation (40%). Hyper leucocytosis (47.4%), anemia and low prothrombin rate (TP) (22.2%) were the most found biological abnormalities. More than 2/3 (68.5%) our patients had an intermediate mortality risk according to the PESI (pulmonary embolism Severity Index) score. The average hospital stay was 10 days. Hospital mortality was 10.5%. Conclusion: The pulmonary embolism of the young person is a frequent, serious and multifactorial pathology and the female sex is most affected especially during peri partum periods, hence the need for preventive measure

关键词： pulmonary embolism Young Subject 15 - 40 Years Cardiology Point G Hospital

Current Concepts in the Diagnosis and Management of pulmonary embolism

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International Journal of Clinical Medicine 2021年第3期12卷 115-129页

作者： Sridhar Kasturi Sunshine Heart Institute Secunderabad Telangana Hyderabad India

Acute pulmonary embolism (PE) is one of the most common causes of cardiovascular death. Most often acute PE is associated with under diagnosis, misdiagnosis and delay in diagnosis and management leading to high morbidity and mortality. PE outcomes will improve with proper evaluation of clinical symptoms and signs, relevant diagnostic tests, identifying high-risk patients suitable for early re-perfusion with I.V. or catheter-directed thrombolytic therapy or surgical embolectomy and in some cases additional use of mechanical circulatory support. During clinical evaluation modified Geneva score, Well’s score, and Simplified pulmonary embolism severity index (sPESI) scores are useful in assessing PE and its adverse outcomes. Hestia criteria are useful in identifying suitable for outpatient management of PE. Long-term management of PE involves identifying patients prone for recurrence and CTPE with appropriate long-term prophylaxis using oral anticoagulants.

关键词： pulmonary embolism Management of PE

Double Emergency pulmonary embolism and Aortic Dissection: About a Clinical Case

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World Journal of Cardiovascular Diseases 2020年第8期10卷 550-557页

作者： Coumba Thiam Boubacar Sonfo Youssouf Camara Souleymane Sanogo Hamidou Oumar Bâ Sidibé Samba Massama Konaté Asmaou Keita Sako Mariam Mahamadou Cissé Ibrahima Sangaré Massama Camara Menta Ichaka Cardiology Department of CHU Kati Bamako Mali Imaging Department CHU Mère-Enfant Bamako Mali Cardiology Department CHU Gabriel Touré Bamako Mali Cardiology Department CHU Point G Bamako Mali Internal Medicine Service Mali Hospital Bamako Mali Cardiology Department CHU Mère-Enfant Bamako Mali

Introduction: pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the... 详细信息

Introduction: Pulmonary embolism and aortic dissection are two formidable cardiovascular emergencies. Their exceptional association has a poor prognosis with very high mortality. The aim of our study was to report the case of a 31-year-old patient with pulmonary embolism associated with De Bakey’s type I aortic dissection, admitted to the cardiology department of Kati University Hospital. Case Presentation: We report the case of a young patient of 31 with no known cardiovascular history, on estrogen-progestogen contraception for 10 years, who consults for a left basal thoracic pain of increasing intensity, a whitish productive cough, hemoptysis and dyspnea stage III. She was admitted to the cardiology department, transthoracic cardiac ultrasound objectified aortic insufficiency, dissection of the aorta, the presence of the intimal flap, the false and the true channel, dilation of the right cavities with HTAP. The chest CT scan revealed bilateral lobar and segmental pulmonary embolism, De Bakey’s type I aortic dissection. Medical treatment was instituted for hemodynamic stabilization at the end of sending her to a center specializing in cardiovascular surgery for better management; unfortunately she succumbed before the preparations for her evacuation were finished. Conclusion: The pulmonary embolism associated with aortic dissection constitutes a medical emergence of rare incidence in a cardiological environment;if the diagnosis was quickly made in our patient, the lack of technical platform made management difficult.

关键词： pulmonary embolism Aortic Dissection CHU Kati

The value of CT pulmonary angiography to the diagnosis of right ventricular dysfunction due to acute pulmonary embolism:compared with ultrasonographic cardiography

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Journal of Nanjing Medical University 2008年第4期22卷 234-237页

作者： Jianguo Wang Li Zhu Min Liu Xiaojuan Guo Chen Wang Youmin Guo Yuanhua Yang Zhenguo Zhai Hongxia Ma Yulin Guo Imaging Center the Second Hospital of Medical College of Xi＇ an Jiao Tong University Xi＇ an 710004Shaanxi Province China Imaging Center Affiliated Hospital of NingXia Medical College Yinchuan 750004 Ningxia Hui Autonomous Region China Radiology department Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences Beijing 100020 China Respiratory Medicine Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences Beijing 100020 China

To analyze the value of CT pulmonary angiography（CTPA） in assessing right ventdcular dysfunction（RVD） after acute pulmonary embolism. Methods：Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography（UCG） within the ensuing 24 hours were retrospectively reviewed. According to the severity of the disease, the patients were divided into the massive PE group（24 cases） and non-massive PE group（12 cases） respectively. CT scans were analyzed for findings suggestive of RVD. Scans were considered positive for RVD if the right ventricle was dilated（RVd/LVd 〉 1） or if the interventricular septum was straightened or deviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVD associated with PE, Results：In all cases, compared with UCG, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, and negative predictive value of CTPA was 84.61%, 78.26%, 3.892, 0.197, 68.75% and 90% respectively. Kappa value was 0.60, which suggested moderate agreement between CTPA and UCG in the whole level. In the massive PE group, the diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value of CTPA was 84.61%, 72.73%, 3.103, 0.212, 78.57% and 80% respectively. Kappa value was 0.58, which suggested moderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group, the diagnostic specificity of CTPA was 83.33%. By statistics, the value of RVd/LVd had significant difference between the massive PE and the non-massive PE group. Conclusion：CTPA can reliably detect RVD through the evaluation of cardiac morphology. However, this result requires confirmation using a larger prospective cohort study.

关键词： pulmonary embolism tomography X-ray computed angiography

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Retrospective Clinical Analysis of 38 Cases of pulmonary embolism

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South China Journal of Cardiology 2007年第4期8卷 183-186,224页

作者： Ruiyun Liang Wei Zhang Wei Wu Shanping Jiang Zhiqiang Lǖ Department of Respiratory Medicine Guangzhou 510120 China Department of cardiology The Second Affiliated Hospital of Sun Yat-sen University Guangzhou 510120 China

Objectives To investigate the clinical feature of acute pulmonary embolism. Methods Retrospective clinical analysis was performed according to the data of 38 cases of pulmonary embolism. Results There were ground diseases and predisposing factors in 36 cases of pulmonary embolism among 38 cases, the ratio was 94. 7%, among the total predisposing factors, tumor, cardiovascular disease, venous thrombosis of lower extremity, smoking and long-term bed were common. There was no specificity in clinical feature, physical sign and rout chest X ray, electrocardiography, and their appearances were diversified. There were specificity and sensitivity in echocardiogram （UCG） and D-dimer to some extent. But, the final diagnosis must depend on some special examinations, such as selective pulmonary arteriography, CTPA, MRA and so on. Conclusions The special examinations must be done to make a definite diagnosis to confirm pulmonary embolism when the high risk factors and ground diseases are existing. It is necessary to some cases when the clinical feature can not be explained by other diseases.

关键词： pulmonary embolism clinical analysis diagnostic method

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The dynamic study of the pulmonary artery obstruction degree and the right ventricular function in massive pulmonary embolism on CT pulmonary angiography

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Journal of Nanjing Medical University 2008年第3期22卷 188-192页

作者： Jianguo Wang Xiaojuan Guo Min Liu Youmin Guo Chen Wang Yuanhua Yang Zhenguo Zhai Li Zhu Hongxia Ma Yulin Guo Imaging Center the Second Affiliated Hospital of Xi＇ an Jiao Tong University Xi＇ an 710004 Shan xi Province China Radiology Department Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences Beijing 100020 China Respiratory Medicine Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences Beijing 100020 China Imaging Center the Affiliated Hospital of Ningxia Medical College Yinchuan 750004 Ningxia Hui Autonomous Region China

Objective： To analyze the value of CTPA in assessing the dissolve of embolus and the function of the right ventricle dynamically. Methods：Twenty-three cases of massive pulmonary embolism were analyzed retrospectively. The pulmonary artery obstruction index and the right ventricular function parameters were collected and analyzed on CTPA before thrombolytic therapy, 24 hours and 14 days after therapy, respectively. Results：The pulmonary artery obstruction index decreased gradually, and there was significant difference before therapy, 24 hours and 2 weeks after therapy. Twenty-four hours after therapy, the maximal short axes diameter and the maximal transverse area of right ventricle（RVd, RV~） decreased significantly, the maximal short axes diameter and the maximal transverse area of left ventricle（LVd, LVs） increased significantly, and the RVd/LVd, RVs/LVS decreased apparently. The pulmonary artery symbolic pressure before and 24 hours after therapy were apparently different. There was no significant difference between azygos vein, the super vena cava, the main pulmonary artery and vein reflux before and after therapy. Conclusion：CTPA can evaluate the pulmonary artery obstruction degree and right ventricular function dynamically.

关键词： pulmonary embolism Tomography, X-ray computed Angiography

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