Journal of the American Society of Echocardiography
Original articleQuantitative Measures of Right Ventricular Dysfunction by Echocardiography in the Diagnosis of Acute Nonmassive Pulmonary Embolism
Section snippets
Patients
The study population consisted of a consecutive series of clinically stable patients older than 18 years, referred for ventilation/perfusion (V/Q) scintigraphy scan to establish the diagnosis of first nonmassive PE. Among 321 patients eligible for inclusion, 21 refused to participate, leaving 300 patients (94%) able to provide informed consent for participation in the study. The study was approved by the local scientific ethical committee.
Among the 300 patients, V/Q scan was cancelled in 3
Results
Patients referred for V/Q scan were age 68 ± 16 years, range 19 to 97 years. In all, 150 patients (53%) were female and 133 (47%) were male. Thirteen V/Q scan results (4%) were of insufficient quality to allow firm interpretation, leaving 283 patients for further analysis. TTE and V/Q scan were performed within a median interval of 1.6 hours (maximal delay 5.6 hours). In all, 58 patients (20%) had PE on the V/Q scan, whereas 119 patients with indeterminate and 106 patient with normal scan
Discussion
Modern quantitative echocardiographic evaluation of RV size, systolic pressure, and function, in particular the RV/LV ratio, the PA acceleration time, and RVOT FS, are important parameters to consider when evaluating patients with suggested nonmassive PE.
However, the sensitivity and predictive values of the TTE parameters alone are too low to be an alternative to established imaging techniques for the final diagnosis of nonmassive PE. But, when adding the echocardiographic information to
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2022, Journal of the American College of RadiologyCitation Excerpt :Although additional studies have focused on the accuracy of these findings on a practical basis, all patients for whom these findings are suggested—either for transesophageal or transthoracic echocardiography—will undergo CTPA to identify a filling defect in the diagnosis of PE [51]. Risk stratification for right ventricular failure when there is a positive CTPA [52-57] is commonly used, but this clinical situation (after a diagnosis of PE) is not within the scope of this document. Literature suggests that PE can be suspected during echocardiography when there is a hypo- or akinetic mid and basal right ventricular free wall associated with a seemingly normal or hyperkinetic right ventricular apical wall motion [50].
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2017, Journal of the American Society of EchocardiographyCitation Excerpt :Our systematic search strategy yielded 5,905 articles without duplicates (7,164 total). Of these, 464 were selected for full text review and 21 were deemed to meet all inclusion criteria and no exclusions for this review (Figure 1 and Table 1).23-46 The percent agreement between the two reviewers for article selection was 94.3%, and Cohen’s kappa was κ = 0.908 (95% CI, 0.836–0.980; P < .001).
Supported by a research fellowship from the Danish Heart Foundation, grant No. 03-2-3-46A-22112 (Dr Kjaergaard).