来自美国波士顿Brigham and Women’s Hospital的Gregory Piazza博士专访：
1. CTPA is wildly used in diagnosis of acute pulmonary embolism. Do you think it is necessary to assess the right ventricle by MSCT？
2. Would you like to tell us the clinical characteristics of elderly patients with deep-vein thrombosis and pulmonary embolism?
3. What is your standard of heart failure diagnosis? Did you include the patients who have diastolic heart failure? And how can we prevent VTE for these patients?
<p><font color="#000080"><strong><img align="left" width="68" height="100" alt="" src="/upload/uploadfiles/GREGORY PIAZZA.jpg" /><br /> Gregory Piazza，MD</strong> <font color="#000000">美国波士顿</font></font><font color="#000000">Brigham and Women’s医院<br /> </font><br /> Dr. Piazza is a Clinical Instructor in Medicine， Harvard Medical School and， after completing his training in Cardiology at the Beth Israel Deaconess Medical Center， is now a Fellow in Vascular Medicine at the Brigham and Women’s Hospital.<br /> <br /> 经《国际循环》顾问委员Samuel Z. Goldhaber教授推荐，<font color="#000000">Gregory Piazza接受了《国际循环》编辑部的采访。</font></p> <p><strong><br /> International Circulation:</strong> CTPA is wildly used in diagnosis of acute pulmonary embolism. Do you think it is necessary to assess the right ventricle by MSCT?<br /> <span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: 宋体; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: #B848"><strong>《国际循环》：</strong></span><span lang="EN-US" style="font-family: Verdana; font-size: 10.5pt; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体">CTPA</span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: Verdana; mso-hansi-font-family: Verdana; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt">已经被广泛应用于诊断急性肺栓塞。请问您认为是否有必要常规通过多排螺旋</span><span lang="EN-US" style="font-family: Verdana; font-size: 10.5pt; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体">CT</span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: Verdana; mso-hansi-font-family: Verdana; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt">来评价患者右心室情况？<br /> </span></p> <p><strong>Dr. Gregory Piazza:</strong> RV enlargement detected by chest CT identifies a population of PE patients at increased risk of adverse events.? Since detection of RV enlargement by CT does not require any additional IV contrast or ionizing radiation and echocardiography may not be available at night and on weekends at many medical centers， the use of CT to detect patients with RV enlargement provides rapid information for risk stratification of PE patients.<br /> <span lang="EN-US" style="font-family: "Times New Roman"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体"><strong>Piazza</strong></span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt"><strong>教授：</strong>用肺</span><span lang="EN-US" style="font-family: "Times New Roman"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体">CT</span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt">探测出右室扩大可以筛选出高风险的肺栓塞患者。由于这种方法不需要额外静脉注射造影剂或增加辐射剂量，并且许多医院不能在夜间和周末进行超声心动图检查，此时应用</span><span lang="EN-US" style="font-family: "Times New Roman"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体">CT</span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt">检测右室扩大可便于对肺栓塞患者迅速进行危险分层。<br /> </span></p> <p><strong>International Circulation:</strong> Would you like to tell us the clinical characteristics of elderly patients with deep-vein thrombosis and pulmonary embolism?<br /> <span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: 宋体; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: #B848"><strong>《国际循环》：</strong></span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: Verdana; mso-hansi-font-family: Verdana; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt">您能否为我们介绍一下老年患者深静脉血栓形成和肺栓塞时的临床特点？<br /> </span></p> <p><strong>Dr. Gregory Piazza:</strong> Elderly patients were more likely to have a high medical acuity with a higher frequency of prior recent hospitalization， chronic obstructive pulmonary disease， and recent immobilization compared with nonelderly patients.Elderly patients were less likely to present with typical deep vein thrombosis symptoms of extremity discomfort and difficulty ambulating.? Despite having a high frequency of comorbid conditions and risk factors for venous thromboembolism， only 41% of elderly patients subsequently diagnosed with deep vein thrombosis had received any prophylaxis.<br /> <span lang="EN-US" style="font-family: "Times New Roman"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt; mso-fareast-font-family: 宋体"><strong>Piazza</strong></span><span style="font-family: 宋体; font-size: 10.5pt; mso-ascii-font-family: ’Times New Roman’; mso-hansi-font-family: ’Times New Roman’; mso-bidi-font-family: ’Times New Roman’; mso-ansi-language: EN-US; mso-fareast-language: ZH-CN; mso-bidi-language: AR-SA; mso-font-kerning: 1.0pt"><strong>教授：</strong>与年轻患者相比，老年患者的临床情况可能更复杂，频繁的住院治疗，合并慢性阻塞性肺疾病，以及各种原因导致的制动。老年患者可能更少
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