1. Doppler imaging predicts cardiac events in chronic pulmonary thromboembolism
- Author
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Shiina, Yumi, Funabashi, Nobusada, Lee, Kwangho, Daimon, Masao, Sekine, Tai, Kawakubo, Miyuki, Sekine, Yukiko, Takahashi, Maiko, Yajima, Rei, Wakatsuki, Yu, Tanabe, Nobuhiro, Kuriyama, Takayuki, and Komuro, Issei
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THROMBOEMBOLISM , *DOPPLER echocardiography , *PULMONARY embolism , *RIGHT heart ventricle diseases , *TRICUSPID valve , *ATRIAL natriuretic peptides , *LOGISTIC regression analysis , *PATIENTS , *DIAGNOSIS - Abstract
Abstract: Purpose: We evaluated whether right ventricular (RV) diastolic dysfunction assessed by pulsed tissue Doppler imaging (TDI) predicts cardiac events in patients with chronic pulmonary thromboembolism (CPTE). Materials and methods: In 63 consecutive patients with CPTE, early diastolic myocardial velocity (Ea) at the tricuspid annulus by TDI and early diastolic tricuspid inflow (E) by conventional pulsed Doppler were obtained, and E/Ea was calculated as an indicator of RV diastolic dysfunction. Brain natriuretic peptide (BNP) and other echo parameters were also obtained. A cardiac event (rehospitalization caused by congestive heart failure or cardiac death) was the study endpoint. Incidence of cardiac events was determined over a 374±451 day follow-up period. Results: In the follow-up period twelve patients had cardiac events. We divided patients into group A with cardiac events and group B without events. E/Ea was significantly increased in group A as compared with group B (8.3±4.1 vs. 5.7±2.6, p <0.01). BNP was higher in group A than group B (221±191 vs. 121±140 mg/dl, p <0.05), and in addition E/Ea was significantly positively correlated with BNP (r=0.48, p <0.001). A logistic regression model for predicting cardiac events was constructed and E/Ea was associated with an increased incidence of cardiac events (relative risk=1.33, 95% CI 1.00–1.75). Conclusion: Elevated values of E/Ea obtained by TDI may predict cardiac events in patients with CPTE. BNP may also be a significant predictor. [Copyright &y& Elsevier]
- Published
- 2009
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