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British Medical Journal May 1966
PubMed: 20790963
DOI: No ID Found -
European Heart Journal. Cardiovascular... Aug 2022
Topics: Humans; Pneumonia; Pulmonary Artery; Pulmonary Infarction; Takayasu Arteritis
PubMed: 35616078
DOI: 10.1093/ehjci/jeac097 -
Medicine Oct 2015In the setting of acute pulmonary embolism (PE), pulmonary infarction is deemed to occur primarily in individuals with compromised cardiac function.The current study was... (Observational Study)
Observational Study
In the setting of acute pulmonary embolism (PE), pulmonary infarction is deemed to occur primarily in individuals with compromised cardiac function.The current study was undertaken to establish the prevalence of pulmonary infarction in patients with acute PE, and the relationship between infarction and: age, body height, body mass index (BMI), smoking habits, clot burden, and comorbidities.The authors studied prospectively 335 patients with acute PE diagnosed by computed tomographic angiography (CT) in 18 hospitals throughout central Italy. The diagnosis of pulmonary infarction on CT was based on Hampton and Castleman's criteria (cushion-like or hemispherical consolidation lying along the visceral pleura). Multivariable logistic regression was used to model the relationship between covariates and the probability of pulmonary infarction.The prevalence of pulmonary infarction was 31%. Patients with infarction were significantly younger and with significantly lower prevalence of cardiovascular disease than those without (P < 0.001). The frequency of infarction increased linearly with increasing height, and decreased with increasing BMI. In logistic regression, the covariates significantly associated with the probability of infarction were age, body height, BMI, and current smoking. The risk of infarction grew with age, peaked at approximately age 40, and decreased afterwards. Increasing body height and current smoking were significant amplifiers of the risk of infarction, whereas increasing BMI appeared to confer some protection.Our data indicate that pulmonary infarction occurs in nearly one-third of the patients with acute PE. Those with infarction are often young and otherwise healthy. Increasing body height and active smoking are predisposing risk factors.
Topics: Acute Disease; Adult; Age Factors; Aged; Aged, 80 and over; Body Height; Body Mass Index; Cardiovascular Diseases; Female; Humans; Italy; Male; Middle Aged; Prevalence; Pulmonary Embolism; Pulmonary Infarction; Risk Factors; Smoking; Tomography, X-Ray Computed
PubMed: 26469892
DOI: 10.1097/MD.0000000000001488 -
Respirology (Carlton, Vic.) Jul 2018
PubMed: 30011423
DOI: 10.1111/resp.13366 -
Expert Review of Respiratory Medicine 2023Given the heterogeneity of predisposing factors associated with pulmonary infarction (PI) and the lack of clinically relevant outcomes among patients with acute...
BACKGROUND
Given the heterogeneity of predisposing factors associated with pulmonary infarction (PI) and the lack of clinically relevant outcomes among patients with acute pulmonary embolism (PE) complicated by PI, further investigation is required.
METHODS
Retrospective study of patients with central PE in an 11-year period. Data were stratified according to the diagnosis of PI. Multivariable logistic regression analysis was used to analyze factors associated with PI development and determine if PI was associated with severe hypoxemic respiratory failure and mechanical ventilation use.
RESULTS
Of 645 patients with central PE, 24% ( = 156) had PI. After adjusting for demographics, comorbidities, and clinical features on admission, only age (OR 0.98, CI 0.96-0.99; = 0.008) was independently associated with PI. Regarding outcomes, 35% ( = 55) had severe hypoxemic respiratory failure, and 19% ( = 29) required mechanical ventilation. After adjusting for demographics, PE severity, and right ventricular dysfunction, PI was independently associated with severe hypoxemic respiratory failure (OR 1.78; CI 1.18-2.69, = 0.005) and mechanical ventilation (OR 1.92; CI 1.14-3.22, = 0.013).
CONCLUSIONS
Aging is a protective factor against PI. In acute central PE, subjects with PI had higher odds of developing severe hypoxemic respiratory failure and requiring mechanical ventilation.
Topics: Humans; Retrospective Studies; Pulmonary Infarction; Respiratory Insufficiency; Pulmonary Embolism; Respiration, Artificial; Acute Disease
PubMed: 37750314
DOI: 10.1080/17476348.2023.2263359 -
The Clinical Respiratory Journal Jun 2021Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating...
INTRODUCTION AND OBJECTIVES
Pulmonary infarction (PI) shares similar symptoms and imaging presentations with community-acquired pneumonia (CAP), which might delay diagnosis and lead to devastating consequences. Noncontrast computed tomography (CT) is the first-line examination for the patients with the respiratory symptoms. This study aimed to investigate a radiomics method to differentiate PI from CAP using noncontrast-enhanced CT.
METHODS
Noncontrast-enhanced CT images of 54 patients with PI and 64 patients with CAP were retrospectively selected. All patients were confirmed using computed tomography pulmonary angiography (CTPA). A radiomics model was built with 18 texture features that showed significant differences between PI and CAP patients. For comparison, a clinical model using clinical biomarkers and an integrated model combining the radiomics and clinical biomarkers were also generated. An experienced radiologist performed diagnoses using the noncontrast-enhanced CT images. The parameters of the models were generated using a training dataset of 61 patients, whereas the performance of the models was evaluated using receiver operating characteristic (ROC) analysis and Harrell's concordance index (C-index) applied to a separate validation dataset of 57 patients.
RESULTS
The integrated model achieved the best performance (C-index 0.760, sensitivity 0.703, specificity 0.867, positive predictive value [PPV] 0.826, and negative predictive value [NPV] 0.765). The radiomics model was better than both the clinical model and the radiologist's interpretations (C-index 0.721, 0.707, 0.665, respectively; sensitivity 0.667, 0.630, 0.593; specificity 0.800, 0.785, 0.733; PPV 0.750, 0.739, 0.667; and NPV 0.727, 0.706, 0.667).
CONCLUSIONS
Radiomics features generated from noncontrast-enhanced CT images allow PI to be differentiated from CAP with considerable accuracy. The radiomics-based method could provide useful information in clinical practice.
Topics: Humans; Pneumonia; Pulmonary Infarction; ROC Curve; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 33686798
DOI: 10.1111/crj.13341 -
The American Journal of Medicine Apr 1982Pulmonary embolism discovered at autopsy is still as prevalent as previously reported in the last three to four decades. Only a certain percentage of pulmonary emboli...
Pulmonary embolism discovered at autopsy is still as prevalent as previously reported in the last three to four decades. Only a certain percentage of pulmonary emboli result in pulmonary infarction. Recently published studies have suggested that importance of the size of the occluded pulmonary artery in the occurrence of infarction. Our study of 45 autopsy subjects in which there were pulmonary emboli shows a 31 percent incidence of pulmonary artery branches of 3 mm in diameter or less, but emboli in larger arteries may show frequent extensions into their smaller distal branches without producing infarct. Pulmonary infarction also occurs more commonly in patients dying of cardiovascular or malignant diseases than it does in those dying of other diseases, and the combination of shock and congestive left heart failure appears to be the most significant hemodynamic risk factor in the development of pulmonary infarction. However, the increased risk of pulmonary infarction in patients with malignancy may not be accounted for by the existence of these two hemodynamic risk factors alone.
Topics: Cardiomegaly; Humans; Lung; Neoplasms; Pulmonary Embolism; Risk; Shock
PubMed: 6462058
DOI: 10.1016/0002-9343(82)90458-2 -
Chest Dec 2017Massive pulmonary emboli can cause an abrupt onset of symptoms simultaneous with large pulmonary artery occlusions. In contrast, the temporal relationship between...
BACKGROUND
Massive pulmonary emboli can cause an abrupt onset of symptoms simultaneous with large pulmonary artery occlusions. In contrast, the temporal relationship between pulmonary vascular occlusion by smaller emboli and the development of symptoms of pulmonary infarction is unknown. We describe the time interval between embolization and the onset of clinical symptoms and signs compatible with pulmonary infarction.
METHODS
We examined the records of 56 patients with hereditary hemorrhagic telangiectasia (HHT) who underwent therapeutic balloon embolization of pulmonary arteriovenous malformation (PAVM) in a single center after noting that some of them experienced symptoms and signs compatible with pulmonary infarction. Because both the times of embolization and the onset of clinical symptoms were documented in medical records, we were able to calculate the time interval between embolic occlusion of vessels and the onset of symptoms.
RESULTS
The records of 56 patients who underwent therapeutic embolization for HHT were examined. Five patients experienced a single episode of pleuritic pain postembolization, and one patient experienced episodes of pleuritic pain after each of two separate embolization procedures. Four of these pleuritic pain events evolved into a complex compatible with pulmonary infarction. The time intervals between embolization and the onset of pleuritic pain in those experiencing the infarction symptoms and signs were 24 hours, 48 ± 4 hours, 65 hours, and 67 hours, respectively.
CONCLUSIONS
The clinically silent time interval between embolization of a pulmonary artery and the onset of symptoms and signs compatible with lung infarction is 24 hours or greater.
Topics: Adult; Arteriovenous Malformations; Balloon Occlusion; Diagnosis, Differential; Diagnostic Techniques, Respiratory System; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pulmonary Artery; Pulmonary Embolism; Pulmonary Infarction; Radiography, Thoracic; Telangiectasia, Hereditary Hemorrhagic; Time Factors; Young Adult
PubMed: 28716646
DOI: 10.1016/j.chest.2017.07.005 -
The Pediatric Infectious Disease Journal Jul 2021
Review
Topics: Anti-Bacterial Agents; Child; Endocarditis, Bacterial; Female; Humans; Micrococcus luteus; Pulmonary Infarction; Tomography, X-Ray Computed
PubMed: 34097668
DOI: 10.1097/INF.0000000000003133 -
Trauma Case Reports Feb 2023Penetrating chest trauma that is associated with pulmonary injuries can trigger different sequelae, the most frequent being the presence of contusions or pulmonary...
BACKGROUND
Penetrating chest trauma that is associated with pulmonary injuries can trigger different sequelae, the most frequent being the presence of contusions or pulmonary lacerations that are accompanied by hemopneumothorax.
MATERIALS AND METHODS
Description of a clinical case of interest and review of the literature on the topic.
RESULTS
In this study, we present an unusual consequence of this type of trauma, a pulmonary infarction secondary to an extensive pulmonary venous thrombosis stemming from a firearm injury. This finding associated with lung tissue necrosis led to the need for right upper pulmonary bilobectomy.
CONCLUSIONS
The aim of this study is to understand this unusual form of presentation of pulmonary trauma, understand the pathophysiology that triggers lung injury, review the medical literature on the subject, and expand the general knowledge on this topic.
STUDY TYPE
Therapeutic/care management.
PubMed: 36660405
DOI: 10.1016/j.tcr.2023.100756