Coronary artery stenosis associated with right ventricular dysfunction in acute pulmonary embolism: A case-control study.
10.1097/CM9.0000000000003729
- Author:
Yuejiao MA
1
;
Jieling MA
2
;
Dan LU
3
;
Yinjian YANG
1
;
Chao LIU
4
;
Liting WANG
4
;
Xijie ZHU
4
;
Xianmei LI
4
;
Chunyan CHENG
4
;
Sijin ZHANG
4
;
Jiayong QIU
5
;
Jinghui LI
6
;
Mengyi LIU
4
;
Kai SUN
1
;
Xin JIANG
4
;
Xiqi XU
2
;
Zhi-Cheng JING
4
Author Information
1. Institute of Clinical Medicine, National Infrastructures for Translational Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
2. Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
3. Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing 100049, China.
4. Department of Cardiovascular Medicine, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong 510080, China.
5. Department of Respiratory and Critical Care Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
6. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
- Publication Type:Multicenter Study
- Keywords:
Coronary artery stenosis;
Pulmonary embolism;
Right ventricular dysfunction;
Systolic pulmonary artery pressure
- MeSH:
Humans;
Pulmonary Embolism/complications*;
Case-Control Studies;
Male;
Ventricular Dysfunction, Right/physiopathology*;
Female;
Middle Aged;
Aged;
Coronary Stenosis/complications*;
Logistic Models;
Adult
- From:
Chinese Medical Journal
2025;138(16):2028-2036
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:The potential impact of pre-existing coronary artery stenosis (CAS) on right ventricular (RV) function during acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and RV dysfunction in patients with acute PE.
METHODS:In this multicenter, case-control study, 89 cases and 176 controls matched for age were enrolled at three study centers (Peking Union Medical College Hospital, Fuwai Hospital, and the Second Affiliated Hospital of Harbin Medical University) from January 2016 to December 2020. The cases were patients with acute PE with CAS, and the controls were patients with acute PE without CAS. Coronary artery assessment was performed using coronary computed tomographic angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression analysis was used to evaluate the association between CAS and RV dysfunction.
RESULTS:The percentages of RV dysfunction (19.1% [17/89] vs. 44.6% [78/176], P <0.001) and elevated systolic pulmonary artery pressure (sPAP) (19.3% [17/89] vs. 39.5% [68/176], P = 0.001) were significantly lower in the case group than those in the control group. In the multivariable logistic regression model, CAS was independently and negatively associated with RV dysfunction (adjusted odds ratio [OR]: 0.367; 95% confidence interval [CI]: 0.185-0.728; P = 0.004), and elevated sPAP (OR: 0.490; 95% CI: 0.252-0.980; P = 0.035), respectively.
CONCLUSIONS:Pre-existing CAS was significantly and negatively associated with RV dysfunction and elevated sPAP in patients with acute PE. This finding provides new insights into RV dysfunction in patients with acute PE with pre-existing CAS.
