An Analogy Between Clot Burden and Right Ventricular Dysfunction in Acute Pulmonary Thromboembolism on Computed Tomography Pulmonary Angiography Using Modified Millers Score: A One Year Hospital Based Cross Sectional Study

Acute pulmonary thromboembolism (PTE) is a common disease which is potentially fatal and has a high mortality rate.The study was to determine correlation between increasing pulmonary embolism thrombus load and right ventricular (RV) dysfunction as demonstrated by CT pulmonary angiography (CTPA) and to determine the thrombus load threshold which indicates impending RV decomposition. To investigate any relationship between pulmonary thrombus load and 2D Echo features of right ventricular dysfunction. CTPA cannot only diagnose the embolism but also assess other underlying chest conditions that can result in similar clinical symptoms

MATERIALS AND METHODS:

Type of study: Prospective analytical observational study

Study duration: January 2024 to December 2024

Ethical committee approval: Obtained

Method of data collection:

• The study is a hospital- based prospective study conducted on 49 patients with PTE who underwent both CTPA (General electronics revolution 128 slice CT scanner) and echocardiography in KLE's Dr Prabhakar Kore Hospital, Belagavi
• The patients underwent CTPA according to the departmental protocol and the scans were the evaluated for the severity of PTE using the modified Miller scoring system and for any features of right ventricular decomposition on the CTPA which was correlated with echo cardiograph features of right ventricular dysfunction.

Inclusion criteria: All patient ages >18 years undergoing CT pulmonary angiography for suspected PTE.

Exclusion criteria: Suboptimal scans and change of diagnosis

Study variables: Load of pulmonary thrombo embolism, short axes of RV/LV and MPA/AA ratio.

Statistical test: Chi-squaretest,Kolmogorov test, Shapiro-Wilk test, independent test

Modified Millers Score

5. The site of the most proximal thrombus demonstrated gives a score (up to a maximum of 16) indicating the number of involved downstream major segmental arteries.
5. Individual major segmental arteries get scored 1.