Determining the Homocysteine and D-Dimer Levels and Multilayer Computed Tomography for Diagnosis of Pulmonary Artery Thromboembolism

The aim of our investigation was to assess the importance of measuring D-dimer and homocysteine levels, along with the use of multilayer computer tomography (CT), in the diagnosis of patients with suspected PATE. According to reports, D-dimer is crucial in the diagnosis of pulmonary embolism. Furthermore, homocysteine has been shown to be a risk factor for thrombosis, vascular disease, and atherosclerosis. The purpose of this chapter is to assess the diagnostic utility of multi-detector computed tomography (CT) in conjunction with D-dimer and homocysteine levels in cases of suspected pulmonary embolism. We examined 54 patients from 18 to 76 years of age, who were suffering from conditions and complaints that are typical of PATE, such as chest pain, haemoptysis, dyspnoea, tachycardia, arterial hypotension and signs of vein thrombosis in the inferior limbs. In these patients, PATE was found in different localizations with varying rates of severity. D-dimer levels were measured in patients with suspected PATE using enzyme-linked immunosorbent assays. Homocysteine levels were determined by an enzymatic method. Pulmoangiography is the method of choice in pulmonary embolism diagnostics. All patients were examined to evaluate the presence of pulmonary embolism by multi-detector CT angiopulmonography. Changes in homocysteine levels can be considered a separate independent factor for PATE diagnostics. The correlation between multi-detector CT angiopulmonography, elevated D-dimer levels, and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. Multi-detector CT angiopulmonography, D-dimer levels and related hyperhomocysteinemia can serve as significant laboratory markers in the diagnosis and treatment efficacy of PATE. The changes in homocysteine levels can be considered as a separate independent factor for PATE diagnostics. The interdependence between D-dimer and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. It can be concluded that multilayer CT pulmoangiography is a non-invasive highly informative method, providing a very low level of complications, and is thus indicated for acute PATE diagnostics, and for control of the disease dynamics after anticoagulation treatment.