학술논문
What is the real incidence of right ventricular affection in patients with acute pulmonary embolism?
Document Type
Academic Journal
Author
Ballas C; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.; Lakkas L; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.; Kardakari O; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.; Konstantinidis A; Respiratory Medicine Department, University Hospital of Ioannina, Ioannina, Greece.; Exarchos K; Respiratory Medicine Department, University Hospital of Ioannina, Ioannina, Greece.; Tsiara S; Second Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece.; Kostikas K; Respiratory Medicine Department, University Hospital of Ioannina, Ioannina, Greece.; Naka KΚ; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.; Michalis LK; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.; Katsouras CS; Second Department of Cardiology, University Hospital of Ioannina, Ioannina, Greece.
Source
Publisher: Taylor & Francis Country of Publication: England NLM ID: 0370570 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1784-973X (Electronic) Linking ISSN: 00015385 NLM ISO Abbreviation: Acta Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Echocardiographic markers of right ventricular dysfunction or pressure overload (RV d/PO ) have been used in risk assessment of patients with acute pulmonary embolism (APE). Nevertheless, the role of echocardiography in these patients is incompletely determined. We evaluated the right ventricular function using 'non-conventional' markers of RV d/PO in patients with APE.
Methods: This was a prospective, single-arm, single-centre study. Consecutive adult patients hospitalised for APE were included. The RV free wall longitudinal strain (RV-FWLS), the fractional area change (FAC), the ratio tricuspid annular plane systolic excursion (TAPSE)/pulmonary arterial systolic pressure (PASP), and the pulmonary vascular resistance (PVR) were evaluated.
Results: One hundred patients (mean age 70.0 ± 13.9 years, female 48%) were screened and 73 had adequate RV-FWLS images. The most common abnormal echocardiographic marker was RV-FWLS (44/73; p < 0.001, for all other echocardiographic indices). Thirty-one patients had either PASP ≥ 36 mmHg or PVR > 2 WU (49.2% of the patients with both indices available). There were significant correlations between RV-FWLS, TAPSE/PASP and PVR with both D-Dimers and B-type natriuretic peptide (BNP), and between FAC and BNP. RF-FWLS differed significantly between patients with a simplified pulmonary embolism severity index (sPESI) score 0 and those with a score ≥1 ( p < 0.001).
Conclusions: RVd/PO coexists with APE in a large proportion of patients. RV-FWLS is the most abnormal echocardiographic sign and is related to clinical and biochemical prognostic indices.
Methods: This was a prospective, single-arm, single-centre study. Consecutive adult patients hospitalised for APE were included. The RV free wall longitudinal strain (RV-FWLS), the fractional area change (FAC), the ratio tricuspid annular plane systolic excursion (TAPSE)/pulmonary arterial systolic pressure (PASP), and the pulmonary vascular resistance (PVR) were evaluated.
Results: One hundred patients (mean age 70.0 ± 13.9 years, female 48%) were screened and 73 had adequate RV-FWLS images. The most common abnormal echocardiographic marker was RV-FWLS (44/73; p < 0.001, for all other echocardiographic indices). Thirty-one patients had either PASP ≥ 36 mmHg or PVR > 2 WU (49.2% of the patients with both indices available). There were significant correlations between RV-FWLS, TAPSE/PASP and PVR with both D-Dimers and B-type natriuretic peptide (BNP), and between FAC and BNP. RF-FWLS differed significantly between patients with a simplified pulmonary embolism severity index (sPESI) score 0 and those with a score ≥1 ( p < 0.001).
Conclusions: RV