1. Assessment of right ventricular function in acute pulmonary embolism.
- Author
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Barrios D, Morillo R, Lobo JL, Nieto R, Jaureguizar A, Portillo AK, Barbero E, Fernandez-Golfin C, Yusen RD, and Jiménez D
- Subjects
- Acute Disease, Aged, Aged, 80 and over, Cause of Death, Comorbidity, Echocardiography, Female, Heart Failure epidemiology, Humans, Male, Middle Aged, Multidetector Computed Tomography, Prognosis, Prospective Studies, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Embolism complications, Pulmonary Embolism epidemiology, Risk Assessment, Severity of Illness Index, Ventricular Dysfunction, Right complications, Ventricular Dysfunction, Right epidemiology, Ventricular Dysfunction, Right physiopathology, Ventricular Function, Right, Mortality, Pulmonary Embolism physiopathology, Ventricular Dysfunction, Right diagnostic imaging
- Abstract
The optimal approach to assess right ventricular (RV) function in patients with acute symptomatic pulmonary embolism (PE) lacks clarity., Methods: This study aimed to evaluate the optimal approach to assess RV function in normotensive patients with acute symptomatic PE. Outcomes assessed through 30-days after the diagnosis of PE included all-cause mortality and complicated course., Results: Eight hundred forty-eight patients were enrolled. Multidetector computed tomography (MDCT) and transthoracic echocardiography agreed on the presence or absence of RV overload in 449 (53%) patients. The combination of the simplified Pulmonary Embolism Severity Index (sPESI) and MDCT showed a negative predictive value for 30-day all-cause mortality of 100%. Of the 43% that had an sPESI of >0 points and MDCT RV enlargement, 41 (11.3%) experienced a complicated course that included 24 (6.6%) deaths. One hundred twenty-nine patients (15%) had an sPESI of >0 points, MDCT, and echocardiographic RV overload. Of these, 21 (16.3%) experienced a complicated course within the first 30days, and 10 (7.7%) of them died., Conclusions: Incorporation of echocardiographic RV overload to the sPESI and MDCT did not improve identification of low-risk PE patients, whereas it improved identification of those at intermediate-high risk for short-term complications., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
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