Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura

Introduction: Acute pulmonary embolism has a mortality rate that reaches up to 58%, with heart adaptation mechanisms to right ventricular strain as the main factor determining outcomes. The gold standard for diagnosis of right ventricular failure is echocardiography, but it has some limitations as i...

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López Donato, Diego Fernando
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Fecha de publicación:
2019
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Universidad Nacional de Colombia
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Universidad Nacional de Colombia
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spa
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Medicina y salud
Tomography X-Ray Computed; Pulmonary Embolism; Ventricular Dysfunction Right; Echocardiography
Tomografía Computarizada por Rayos X; Embolia Pulmonar; Disfunción Ventricular Derecha; Ecocardiografía
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id UNACIONAL2_598732d60b41ba650586ebef0fb4fb70
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network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
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dc.title.spa.fl_str_mv Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
title Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
spellingShingle Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
Medicina y salud
Tomography X-Ray Computed; Pulmonary Embolism; Ventricular Dysfunction Right; Echocardiography
Tomografía Computarizada por Rayos X; Embolia Pulmonar; Disfunción Ventricular Derecha; Ecocardiografía
title_short Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
title_full Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
title_fullStr Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
title_full_unstemmed Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
title_sort Evaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literatura
dc.creator.fl_str_mv López Donato, Diego Fernando
dc.contributor.advisor.spa.fl_str_mv Carillo Bayona, Jorge Alberto
Salazar, Luis Carlos
dc.contributor.author.spa.fl_str_mv López Donato, Diego Fernando
dc.contributor.researchgroup.spa.fl_str_mv GRUPO DE INVESTIGACIÓN EN RADIOLOGÍA E IMÁGENES DIAGNÓSTICAS (GRID)
dc.subject.ddc.spa.fl_str_mv Medicina y salud
topic Medicina y salud
Tomography X-Ray Computed; Pulmonary Embolism; Ventricular Dysfunction Right; Echocardiography
Tomografía Computarizada por Rayos X; Embolia Pulmonar; Disfunción Ventricular Derecha; Ecocardiografía
dc.subject.proposal.eng.fl_str_mv Tomography X-Ray Computed; Pulmonary Embolism; Ventricular Dysfunction Right; Echocardiography
dc.subject.proposal.spa.fl_str_mv Tomografía Computarizada por Rayos X; Embolia Pulmonar; Disfunción Ventricular Derecha; Ecocardiografía
description Introduction: Acute pulmonary embolism has a mortality rate that reaches up to 58%, with heart adaptation mechanisms to right ventricular strain as the main factor determining outcomes. The gold standard for diagnosis of right ventricular failure is echocardiography, but it has some limitations as it is operator dependent and the technical difficulties of acquiring adequate images of the right cardiac chambers. There have been performed some trials testing conventional tomography (CT) as a diagnostic tool for determining hemodynamic alterations derived from this pathology, however none of them has demonstrated an acceptable diagnostic performance. Along with the advent of new CT technologies having better acquisition hardware and post-processing software, it has been possible to measure the cardiac chamber volumes to make appropriate comparisons with those obtained through echocardiography. Objective: to perform a systematic review of the diagnostic validity of cardiac chamber volume determined on ECG-gated heart CT for the diagnosis of right ventricular failure. Materials and methods: it was performed a systematic review on the validity of cardiac volumetric measurements calculated through ECG-gated heart CT as a diagnostic tool compared with those obtained through echocardiography as it is the reference standard in diagnosis of right ventricular failure, finding a combined sensitivity of 0.89 % (0.76-0.95; CI 95) and a specificity of 87% (9.79-9.93%; CI 95). Conclusions: actual scientific evidence supports the use of heart chamber volume measurements obtained through ECG-gated heart CT as a diagnostic tool in determining right ventricular failure on patients having an acute pulmonary embolism, with a good diagnostic performance.
publishDate 2019
dc.date.issued.spa.fl_str_mv 2019-11-20
dc.date.accessioned.spa.fl_str_mv 2020-01-30T18:55:51Z
dc.date.available.spa.fl_str_mv 2020-01-30T18:55:51Z
dc.type.spa.fl_str_mv Documento de trabajo
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/workingPaper
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_8042
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/WP
format http://purl.org/coar/resource_type/c_8042
status_str acceptedVersion
dc.identifier.citation.spa.fl_str_mv Agnelli G, Becattini C. Acute pulmonary embolism [11]. N Engl J Med [Internet]. 2010;363(20):1974–5. Available from: http://dx.doi.org/10.1016/j.thorsurg.2009.12.010
Article R, Steering I, For C, Thrombosis W. Thrombosis : a major contributor to the global disease burden. 2014;(August):1580–90.
Stein PD, Beemath A, Olson RE. Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol. 2005;95(12):1525–6.
Konstantinides S V, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2019;1–61.
Huisman M V, Barco S, Cannegieter SC, Gal G Le. Pulmonary embolism Nature 2018. Nat Rev Dis Prim. 2018;VOLUME 4(May):18.
Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: A predictor of early death in acute pulmonary embolism. Circulation. 2004;110(20):3276–80.
Ilker I, Altınsoy B, Serifoglu I, Sayın R, Cagatay M, Erboy F, et al. Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography : Prediction of adverse outcome and 30-day mortality. Eur J Radiol [Internet]. 2015;84(12):2526–32. Available from: http://dx.doi.org/10.1016/j.ejrad.2015.08.019
Jiménez D, Lobo JL, Monreal M, Moores L, Oribe M, Barrón M, et al. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: Results of the protect study. Thorax. 2014;69(2):109–15.
Scheffel H, Stolzmann P, Leschka S, Desbiolles L, Seifert B, Marincek B, et al. Ventricular short-axis measurements in patients with pulmonary embolism : Effect of ECG-gating on variability , accuracy , and risk prediction. Eur J Radiol [Internet]. 2012;81(9):2195–202. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.03.067
Aviram G, Soikher E, Bendet A, Shmueli H, Ziv-Baran T, Amitai Y, et al. Prediction of Mortality in Pulmonary Embolism Based on Left Atrial Volume Measured on CT Pulmonary Angiography. Chest [Internet]. 2016;149(3):667–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26356029
Daley J, Grotberg J, Pare J, Medoro A, Liu R, Hall MK, et al. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism. Am J Emerg Med [Internet]. 2017;35(1):106–11. Available from: http://dx.doi.org/10.1016/j.ajem.2016.10.018
Apfaltrer P, Henzler T, Meyer M, Roeger S, Haghi D, Gruettner J, et al. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(10):2867–71. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.08.014
Meyer M, Fink C, Roeger S, Apfaltrer P, Haghi D, Kaminski WE, et al. Benefit of combining quantitative cardiac CT parameters with troponin i for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(11):3294–9. Available from: http://dx.doi.org/10.1016/j.ejrad.2012.06.023
Henzler T, Roeger S, Meyer M, Schoepf UJ, Nance JW, Haghi D, et al. Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction. Eur Respir J. 2012;39(4):919–26.
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/75543
identifier_str_mv Agnelli G, Becattini C. Acute pulmonary embolism [11]. N Engl J Med [Internet]. 2010;363(20):1974–5. Available from: http://dx.doi.org/10.1016/j.thorsurg.2009.12.010
Article R, Steering I, For C, Thrombosis W. Thrombosis : a major contributor to the global disease burden. 2014;(August):1580–90.
Stein PD, Beemath A, Olson RE. Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol. 2005;95(12):1525–6.
Konstantinides S V, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2019;1–61.
Huisman M V, Barco S, Cannegieter SC, Gal G Le. Pulmonary embolism Nature 2018. Nat Rev Dis Prim. 2018;VOLUME 4(May):18.
Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: A predictor of early death in acute pulmonary embolism. Circulation. 2004;110(20):3276–80.
Ilker I, Altınsoy B, Serifoglu I, Sayın R, Cagatay M, Erboy F, et al. Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography : Prediction of adverse outcome and 30-day mortality. Eur J Radiol [Internet]. 2015;84(12):2526–32. Available from: http://dx.doi.org/10.1016/j.ejrad.2015.08.019
Jiménez D, Lobo JL, Monreal M, Moores L, Oribe M, Barrón M, et al. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: Results of the protect study. Thorax. 2014;69(2):109–15.
Scheffel H, Stolzmann P, Leschka S, Desbiolles L, Seifert B, Marincek B, et al. Ventricular short-axis measurements in patients with pulmonary embolism : Effect of ECG-gating on variability , accuracy , and risk prediction. Eur J Radiol [Internet]. 2012;81(9):2195–202. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.03.067
Aviram G, Soikher E, Bendet A, Shmueli H, Ziv-Baran T, Amitai Y, et al. Prediction of Mortality in Pulmonary Embolism Based on Left Atrial Volume Measured on CT Pulmonary Angiography. Chest [Internet]. 2016;149(3):667–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26356029
Daley J, Grotberg J, Pare J, Medoro A, Liu R, Hall MK, et al. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism. Am J Emerg Med [Internet]. 2017;35(1):106–11. Available from: http://dx.doi.org/10.1016/j.ajem.2016.10.018
Apfaltrer P, Henzler T, Meyer M, Roeger S, Haghi D, Gruettner J, et al. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(10):2867–71. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.08.014
Meyer M, Fink C, Roeger S, Apfaltrer P, Haghi D, Kaminski WE, et al. Benefit of combining quantitative cardiac CT parameters with troponin i for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(11):3294–9. Available from: http://dx.doi.org/10.1016/j.ejrad.2012.06.023
Henzler T, Roeger S, Meyer M, Schoepf UJ, Nance JW, Haghi D, et al. Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction. Eur Respir J. 2012;39(4):919–26.
url https://repositorio.unal.edu.co/handle/unal/75543
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.references.spa.fl_str_mv 1. Agnelli G, Becattini C. Acute pulmonary embolism [11]. N Engl J Med [Internet]. 2010;363(20):1974–5. Available from: http://dx.doi.org/10.1016/j.thorsurg.2009.12.010 2. Article R, Steering I, For C, Thrombosis W. Thrombosis : a major contributor to the global disease burden. 2014;(August):1580–90. 3. Stein PD, Beemath A, Olson RE. Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol. 2005;95(12):1525–6. 4. Konstantinides S V, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2019;1–61. 5. Huisman M V, Barco S, Cannegieter SC, Gal G Le. Pulmonary embolism Nature 2018. Nat Rev Dis Prim. 2018;VOLUME 4(May):18. 6. Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: A predictor of early death in acute pulmonary embolism. Circulation. 2004;110(20):3276–80. 7. Ilker I, Altınsoy B, Serifoglu I, Sayın R, Cagatay M, Erboy F, et al. Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography : Prediction of adverse outcome and 30-day mortality. Eur J Radiol [Internet]. 2015;84(12):2526–32. Available from: http://dx.doi.org/10.1016/j.ejrad.2015.08.019 8. Jiménez D, Lobo JL, Monreal M, Moores L, Oribe M, Barrón M, et al. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: Results of the protect study. Thorax. 2014;69(2):109–15. 9. Scheffel H, Stolzmann P, Leschka S, Desbiolles L, Seifert B, Marincek B, et al. Ventricular short-axis measurements in patients with pulmonary embolism : Effect of ECG-gating on variability , accuracy , and risk prediction. Eur J Radiol [Internet]. 2012;81(9):2195–202. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.03.067 10. Aviram G, Soikher E, Bendet A, Shmueli H, Ziv-Baran T, Amitai Y, et al. Prediction of Mortality in Pulmonary Embolism Based on Left Atrial Volume Measured on CT Pulmonary Angiography. Chest [Internet]. 2016;149(3):667–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26356029 11. Daley J, Grotberg J, Pare J, Medoro A, Liu R, Hall MK, et al. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism. Am J Emerg Med [Internet]. 2017;35(1):106–11. Available from: http://dx.doi.org/10.1016/j.ajem.2016.10.018 12. Apfaltrer P, Henzler T, Meyer M, Roeger S, Haghi D, Gruettner J, et al. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(10):2867–71. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.08.014 13. Meyer M, Fink C, Roeger S, Apfaltrer P, Haghi D, Kaminski WE, et al. Benefit of combining quantitative cardiac CT parameters with troponin i for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(11):3294–9. Available from: http://dx.doi.org/10.1016/j.ejrad.2012.06.023 14. Henzler T, Roeger S, Meyer M, Schoepf UJ, Nance JW, Haghi D, et al. Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction. Eur Respir J. 2012;39(4):919–26.
dc.rights.spa.fl_str_mv Derechos reservados - Universidad Nacional de Colombia
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dc.rights.license.spa.fl_str_mv Atribución-NoComercial 4.0 Internacional
dc.rights.spa.spa.fl_str_mv Acceso abierto
dc.rights.uri.spa.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv Atribución-NoComercial 4.0 Internacional
Derechos reservados - Universidad Nacional de Colombia
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dc.coverage.sucursal.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
dc.publisher.branch.spa.fl_str_mv Universidad Nacional de Colombia - Sede Bogotá
institution Universidad Nacional de Colombia
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spelling Atribución-NoComercial 4.0 InternacionalDerechos reservados - Universidad Nacional de ColombiaAcceso abiertohttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Carillo Bayona, Jorge Alberto684a195d-8a8b-4411-ba19-7ecad1cf90c3-1Salazar, Luis Carlosd0255c8a-ccb4-4d3e-9881-bf2415b20efa-1López Donato, Diego Fernando91594fa5-dc2f-456b-97a9-a5db76968009GRUPO DE INVESTIGACIÓN EN RADIOLOGÍA E IMÁGENES DIAGNÓSTICAS (GRID)2020-01-30T18:55:51Z2020-01-30T18:55:51Z2019-11-20Agnelli G, Becattini C. Acute pulmonary embolism [11]. N Engl J Med [Internet]. 2010;363(20):1974–5. Available from: http://dx.doi.org/10.1016/j.thorsurg.2009.12.010Article R, Steering I, For C, Thrombosis W. Thrombosis : a major contributor to the global disease burden. 2014;(August):1580–90.Stein PD, Beemath A, Olson RE. Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol. 2005;95(12):1525–6.Konstantinides S V, Meyer G, Becattini C, Bueno H, Geersing G-J, Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2019;1–61.Huisman M V, Barco S, Cannegieter SC, Gal G Le. Pulmonary embolism Nature 2018. Nat Rev Dis Prim. 2018;VOLUME 4(May):18.Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: A predictor of early death in acute pulmonary embolism. Circulation. 2004;110(20):3276–80.Ilker I, Altınsoy B, Serifoglu I, Sayın R, Cagatay M, Erboy F, et al. Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography : Prediction of adverse outcome and 30-day mortality. Eur J Radiol [Internet]. 2015;84(12):2526–32. Available from: http://dx.doi.org/10.1016/j.ejrad.2015.08.019Jiménez D, Lobo JL, Monreal M, Moores L, Oribe M, Barrón M, et al. Prognostic significance of multidetector CT in normotensive patients with pulmonary embolism: Results of the protect study. Thorax. 2014;69(2):109–15.Scheffel H, Stolzmann P, Leschka S, Desbiolles L, Seifert B, Marincek B, et al. Ventricular short-axis measurements in patients with pulmonary embolism : Effect of ECG-gating on variability , accuracy , and risk prediction. Eur J Radiol [Internet]. 2012;81(9):2195–202. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.03.067Aviram G, Soikher E, Bendet A, Shmueli H, Ziv-Baran T, Amitai Y, et al. Prediction of Mortality in Pulmonary Embolism Based on Left Atrial Volume Measured on CT Pulmonary Angiography. Chest [Internet]. 2016;149(3):667–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26356029Daley J, Grotberg J, Pare J, Medoro A, Liu R, Hall MK, et al. Emergency physician performed tricuspid annular plane systolic excursion in the evaluation of suspected pulmonary embolism. Am J Emerg Med [Internet]. 2017;35(1):106–11. Available from: http://dx.doi.org/10.1016/j.ajem.2016.10.018Apfaltrer P, Henzler T, Meyer M, Roeger S, Haghi D, Gruettner J, et al. Correlation of CT angiographic pulmonary artery obstruction scores with right ventricular dysfunction and clinical outcome in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(10):2867–71. Available from: http://dx.doi.org/10.1016/j.ejrad.2011.08.014Meyer M, Fink C, Roeger S, Apfaltrer P, Haghi D, Kaminski WE, et al. Benefit of combining quantitative cardiac CT parameters with troponin i for predicting right ventricular dysfunction and adverse clinical events in patients with acute pulmonary embolism. Eur J Radiol [Internet]. 2012;81(11):3294–9. Available from: http://dx.doi.org/10.1016/j.ejrad.2012.06.023Henzler T, Roeger S, Meyer M, Schoepf UJ, Nance JW, Haghi D, et al. Pulmonary embolism: CT signs and cardiac biomarkers for predicting right ventricular dysfunction. Eur Respir J. 2012;39(4):919–26.https://repositorio.unal.edu.co/handle/unal/75543Introduction: Acute pulmonary embolism has a mortality rate that reaches up to 58%, with heart adaptation mechanisms to right ventricular strain as the main factor determining outcomes. The gold standard for diagnosis of right ventricular failure is echocardiography, but it has some limitations as it is operator dependent and the technical difficulties of acquiring adequate images of the right cardiac chambers. There have been performed some trials testing conventional tomography (CT) as a diagnostic tool for determining hemodynamic alterations derived from this pathology, however none of them has demonstrated an acceptable diagnostic performance. Along with the advent of new CT technologies having better acquisition hardware and post-processing software, it has been possible to measure the cardiac chamber volumes to make appropriate comparisons with those obtained through echocardiography. Objective: to perform a systematic review of the diagnostic validity of cardiac chamber volume determined on ECG-gated heart CT for the diagnosis of right ventricular failure. Materials and methods: it was performed a systematic review on the validity of cardiac volumetric measurements calculated through ECG-gated heart CT as a diagnostic tool compared with those obtained through echocardiography as it is the reference standard in diagnosis of right ventricular failure, finding a combined sensitivity of 0.89 % (0.76-0.95; CI 95) and a specificity of 87% (9.79-9.93%; CI 95). Conclusions: actual scientific evidence supports the use of heart chamber volume measurements obtained through ECG-gated heart CT as a diagnostic tool in determining right ventricular failure on patients having an acute pulmonary embolism, with a good diagnostic performance.Introducción: La mortalidad del embolismo pulmonar agudo puede llegar hasta el 58% siendo la adaptación del corazón a la sobrecarga ventricular derecha el factor que determina la evolución clínica. El método diagnóstico de referencia de falla ventricular es la ecocardiografía, con las limitaciones de ser operador dependiente y la dificultad técnica para valorar las cavidades derechas. Se han evaluado varios hallazgos en las imágenes de tomografía convencional para determinar el compromiso hemodinámico sin embargo ninguna ha demostrado un adecuado rendimiento diagnóstico. Con el advenimiento de nuevas tecnologías tomográficas, tanto en la adquisición como en el postproceso, es posible realizar una valoración de los volúmenes cardíacos que se podrían extrapolar a los hallazgos ecocardiográficos. Objetivo: Revisar sistemáticamente la validez diagnóstica de los volúmenes cardíacos por angiotomografía en el diagnóstico de falla del ventrículo derecho. Materiales y métodos: se realizó una revisión sistemática sobre la validez de los parámetros volumétricos cardiacos calculados por angiotomografía comparados con los obtenidos con ecocardiograma como estándar de referencia para el diagnóstico de falla ventricular derecha. Resultados: se calculó para la relación vVD/vVI como criterio diagnóstico de falla ventricular derecha una sensibilidad combinada de 0.89% (0,76-0.95% IC) y especificidad de 87% (0,79-0,93% IC). Conclusiones: la evidencia actual apoya la utilización de los volúmenes cardiacos angiotomográficos como diagnóstico de falla ventricular derecha en pacientes con embolia pulmonar aguda con un buen rendimiento diagnóstico.Especialista en Radiología e Imágenes Diagnósticas. Línea de Investigación: Imagen Corporal.46application/pdfspaMedicina y saludTomography X-Ray Computed; Pulmonary Embolism; Ventricular Dysfunction Right; EchocardiographyTomografía Computarizada por Rayos X; Embolia Pulmonar; Disfunción Ventricular Derecha; EcocardiografíaEvaluación volumétrica cardíaca por angiotomografía y falla del ventrículo derecho en pacientes con embolia pulmonar aguda: revisión sistemática de la literaturaDocumento de trabajoinfo:eu-repo/semantics/workingPaperinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_8042Texthttp://purl.org/redcol/resource_type/WPUniversidad Nacional de Colombia - Sede BogotáUniversidad Nacional de Colombia - Sede Bogotá1. 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Eur Respir J. 2012;39(4):919–26.ORIGINALRevision sistematica Volumetria cardiacas EP para PDF.pdfRevision sistematica Volumetria cardiacas EP para PDF.pdfapplication/pdf699771https://repositorio.unal.edu.co/bitstream/unal/75543/1/Revision%20sistematica%20Volumetria%20cardiacas%20EP%20para%20PDF.pdf672089431f417ed79484b043816c3d0aMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-83991https://repositorio.unal.edu.co/bitstream/unal/75543/2/license.txt6f3f13b02594d02ad110b3ad534cd5dfMD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8701https://repositorio.unal.edu.co/bitstream/unal/75543/3/license_rdf42fd4ad1e89814f5e4a476b409eb708cMD53THUMBNAILRevision sistematica Volumetria cardiacas EP para PDF.pdf.jpgRevision sistematica Volumetria cardiacas EP para PDF.pdf.jpgGenerated 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W5pbyBww7pibGljby4gU2kgbm8gZnVlc2UgZWwgY2FzbywgYWNlcHRvIHRvZGEgbGEgcmVzcG9uc2FiaWxpZGFkIHBvciBjdWFscXVpZXIgaW5mcmFjY2nDs24gZGUgZGVyZWNob3MgZGUgYXV0b3IgcXVlIGNvbmxsZXZlIGxhIGRpc3RyaWJ1Y2nDs24gZGUgZXN0b3MgYXJjaGl2b3MgeSBtZXRhZGF0b3MuCkFsIGhhY2VyIGNsaWMgZW4gZWwgc2lndWllbnRlIGJvdMOzbiwgdXN0ZWQgaW5kaWNhIHF1ZSBlc3TDoSBkZSBhY3VlcmRvIGNvbiBlc3RvcyB0w6lybWlub3MuCg==

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