Background
Methods
Study population
Echo-derived parameters of RV function
RV longitudinal strain
Statistical analysis
Parameter (n) | All patients | Non-Survivors | Survivors | p-Value |
---|---|---|---|---|
69 | 14 | 55 | ||
Age at Diagnosis (69) | 55 [43–72] | 60 [53.5–69.8] | 50 [42.5–72] | 0.11 |
Female Gender (69) | 33 (48) | 6 (42.86) | 27 (49.09) | 0.77 |
Body Mass Index (69) | 27 [23–28] | 26.5 [22.2–27] | 27 [23–28] | 0.42 |
Vital Signs: | ||||
Systolic Blood Pressure (66) | 118 [107–137] | 111 [99.5–144.8] | 118 [109–136.5] | 0.38 |
Diastolic Blood Pressure (66) | 73 [61.5–81.5] | 65 [60.8–71] | 75.5 [63.5–83.8] | 0.08 |
Heart Rate (66) | 94 [84–111.5] | 115 [102.2–125.5] | 90 [81.8–105.8] | 0.02 |
Respiratory Rate (66) | 20 [18–24] | 24 [21.5–28] | 20 [18–24] | 0.01 |
Fraction of Inspired Oxygen (69) | 0.2 [0.2–0.3] | 0.3 [0.2–0.4] | 0.2 [0.2–0.3] | 0.01 |
Troponin T level (ng/mL) (23) | 0.1 [0–0.3] | 0.6 [0.5–0.7] | 0.1 [0–0.2] | <0.01 |
Medical History | ||||
Essential Hypertension (69) | 25 (36.23) | 9 (64.29) | 16 (29.09) | 0.03 |
Type II Diabetes (69) | 4 (5.8) | 1 (7.14) | 3 (5.45) | >0.99 |
Hypothyroidism (69) | 6 (8.7) | 1 (7.14) | 5 (9.09) | >0.99 |
Chronic Kidney Disease (69) | 3 (4.35) | 1 (7.14) | 2 (3.64) | 0.5 |
Previous Venous Thromboembolism (69) | 9 (13.04) | 0 (0) | 9 (16.36) | 0.19 |
Connective Tissue Disease (69) | 2 (2.9) | 1 (7.14) | 1 (1.82) | 0.37 |
Active Malignancy (69) | 20 (28.99) | 8 (57.14) | 12 (21.82) | 0.02 |
Orthopedic Fracture or Injury (69) | 5 (7.25) | 0 (0) | 5 (9.09) | 0.58 |
Chronic Obstructive Pulmonary Disease (69) | 5 (7.25) | 3 (21.43) | 2 (3.64) | 0.05 |
Shortness of Breath: | ||||
NYHA class1 | 2 (2.9) | 0 (0) | 2 (3.64) | |
NYHA class2 | 5 (7.25) | 1 (7.14) | 4 (7.27) | |
NYHA class3 | 15 (21.74) | 1 (7.14) | 14 (25.45) | |
NYHA class4 | 47 (68.12) | 12 (85.71) | 35 (63.64) | |
Pulmonary Embolism Severity Index (PESI) class (69) | <0.01 | |||
Class 1 | 32 (46.38) | 1 (7.14) | 31 (56.36) | |
Class 2 | 10 (14.49) | 2 (14.29) | 8 (14.55) | |
Class 3 | 17 (24.64) | 5 (35.71) | 12 (21.82) | |
Class 4 | 10 (14.49) | 6 (42.86) | 4 (7.27) |
Overall | Non-Survivors | Survivors | p-Value | |
---|---|---|---|---|
Parameter (n) | 69 | 14 | 55 | |
TAPSE (52) (cm) | 1.9 [1.5–2.3] | 2.1 [1.2–2.4] | 1.9 [1.6–2.2] | 0.82 |
Global RVLS (69) (%) | −18.1 [−20.8–14.9] | −15.7 [−19.2–12.1] | −18.6 [−21.8–15.6] | 0.05 |
Average Septal RV Wall strain (69) (%) | −17.8 [−22.7–13.9] | −16.8 [−18.6–9.3] | −17.8 [−22.9–14.7] | 0.20 |
Average Free Wall RV Wall strain (69) (%) | −18.2 [−22.8–13.9] | −15 [−18.7–10.3] | −19.2 [−23.2–14.3] | 0.04 |
RV Tei Index (59) | 0.5 [0.4–0.5] | 0.5 [0.5–0.6] | 0.5 [0.4–0.5] | 0.01 |
Pulmonary Artery Acceleration Time (64) (ms × 10) | 9.5 [7–12] | 9 [7–10] | 10 [7–12] | 0.58 |
RV/LV ratio in systole (52) | 1 [0.8–1.4] | 1.1 [1–1.4] | 1 [0.8–1.5] | 0.74 |
RV/LV ratio in diastole (52) | 0.7 [0.6–0.9] | 0.8 [0.7–1] | 0.7 [0.6–0.9] | 0.35 |
RV base (42) (cm) | 3.8 [3.3–4.3] | 4.2 [3.5–4.3] | 3.7 [3.3–4.3] | 0.61 |
RV middle (39) (cm) | 3.3 [2.9–3.6] | 3.5 [3–4.5] | 3.3 [2.9–3.6] | 0.31 |
RV length (39) (cm) | 7.5 [7–7.9] | 7.5 [7.2–7.8] | 7.5 [6.9–7.9] | 0.61 |
RV diastolic diameter (52) (cm) | 2.7 [2.1–3.1] | 2.7 [2.3–3.1] | 2.7 [2.1–3.2] | 0.41 |
LV diastolic diameter (52) (cm) | 3.5 [2.9–4.1] | 3.2 [2.9–3.8] | 3.6 [3–4.2] | 0.63 |
RV systolic diameter (52) (cm) | 2.4 [2.1–2.9] | 2.6 [2.2–2.9] | 2.4 [2–2.9] | 0.57 |
LV systolic diameter (34) (cm) | 2.3 [1.9–2.7] | 2.2 [1.9–3] | 2.4 [2–2.6] | 0.65 |
RV fractional area change (67) (%) | 34.4 [27.6–43.1] | 27.9 [19.6–35.8] | 38.6 [28.9–43.8] | 0.02 |
RV area in diastole (67) (cm2) | 24.3 [19.9–31] | 25 [22–44] | 24.1 [19.3–29.8] | 0.22 |
RV area in Systole (67) (cm2) | 16.8 [11.4–19.6] | 16.8 [14.6–26.3] | 16.9 [11.1–19.4] | 0.20 |
RV basal free wall strain (69) (%) | −21.4 [−27.4–13.5] | −14.8 [−23.9–10.9] | −22.4 [−28.2–16.1] | 0.06 |
RV middle free wall strain (69) (%) | −16.3 [−22.6–9.5] | −12.4 [−14.5–9.2] | −17.9 [−23.5–9.8] | 0.10 |
RV apical free wall strain (69) (%) | −13.9 [−21.4–8.3] | −11.4 [−15.2–7.7] | −14.9 [−21.4–9.2] | 0.33 |
RV basal septal strain (69) (%) | −19 [−24.5–13.9] | −17.1 [−20.1–13] | −19.6 [−24.8–13.9] | 0.23 |
RV middle septal strain (69) (%) | −18.4 [−23.3–13.7] | −15.6 [−22.8–8.5] | −19 [−22.8–14.2] | 0.32 |
RV apical septal strain (69) (%) | −16 [−19.7–9.5] | −12.1 [−17.7–7] | −16.4 [−19.9–9.8] | 0.15 |
RV subjective size | 0.28 | |||
Normal RV size | 39 (56.52) | 7 (50) | 32 (58.18) | |
Mild RV dilation | 11 (15.94) | 3 (21.43) | 8 (14.55) | |
Moderate RV dilation | 12 (17.39) | 1 (7.14) | 11 (20) | |
Severe RV dilation | 7 (10.14) | 3 (21.43) | 4 (7.27) | |
RV subjective function | 0.60 | |||
Normal RV function | 38 (55.07) | 6 (42.86) | 32 (58.18) | |
Mildly reduced RV function | 10 (14.49) | 2 (14.29) | 8 (14.55) | |
Moderately reduced RV function | 15 (21.74) | 4 (28.57) | 11 (20) | |
Severely reduced RV function | 6 (8.7) | 2 (14.29) | 4 (7.27) | |
LV ejection fraction (69) | 0.07 | |||
LV ejection fraction < 40 % | 6 (8.7) | 3 (21.43) | 3 (5.45) | |
LV ejection fraction 40–50 % | 6 (8.7) | 2 (14.29) | 4 (7.27) | |
LV ejection fraction >50 % | 57 (82.61) | 9 (64.29) | 48 (87.27) |
OR | 2.5 % | 97.5 % | Estimate | SE | Z | p-value | |
---|---|---|---|---|---|---|---|
Age at Diagnosis (69) (years) | 0.98 | 0.94 | 1.01 | −0.02 | 0.02 | −1.44 | 0.15 |
Female Gender (69) | 1.29 | 0.39 | 4.20 | 0.25 | 0.60 | 0.42 | 0.68 |
Body Mass Index (69) (kg/m2) | 1.06 | 0.93 | 1.20 | 0.06 | 0.06 | 0.87 | 0.39 |
Systolic blood pressure (66) (mmHg) | 1.01 | 0.99 | 1.04 | 0.01 | 0.01 | 0.91 | 0.36 |
Diastolic blood pressure (66) (mmHg) | 1.04 | 1.00 | 1.10 | 0.04 | 0.02 | 1.80 | 0.07 |
Malignancy (69) | 0.21 | 0.06 | 0.72 | −1.56 | 0.63 | −2.48 | 0.01 |
Troponin T (23) (ng/mL) | 0.00 | 0.00 | 0.52 | −13.18 | 6.39 | −2.06 | 0.04 |
CK-MB (50) (ng/mL) | 0.99 | 0.93 | 1.04 | −0.01 | 0.03 | −0.52 | 0.60 |
Mild subjective RV dilation (69) | 0.58 | 0.12 | 2.77 | −0.54 | 0.80 | −0.68 | 0.50 |
Moderate subjective RV dilation (69) | 2.41 | 0.27 | 21.81 | 0.88 | 1.12 | 0.78 | 0.43 |
Severe subjective RV dilation (69) | 0.29 | 0.05 | 1.61 | −1.23 | 0.87 | −1.42 | 0.16 |
Mild subjective RV dysfunction (69) | 0.75 | 0.13 | 4.44 | −0.29 | 0.91 | −0.32 | 0.75 |
Moderate subjective RV dysfunction (69) | 0.52 | 0.12 | 2.17 | −0.66 | 0.73 | −0.90 | 0.37 |
Severe subjective RV dysfunction (69) | 0.37 | 0.06 | 2.53 | −0.98 | 0.97 | −1.01 | 0.31 |
LV ejection fraction 40–50 % (69) | 2.00 | 0.19 | 20.61 | 0.69 | 1.19 | 0.58 | 0.56 |
LV ejection fraction > 50 %(69) | 5.33 | 0.93 | 30.74 | 1.67 | 0.89 | 1.87 | 0.06 |
Global RVLS (69) (%) | 0.88 | 0.78 | 0.99 | −0.13 | 0.06 | −2.13 | 0.03 |
Free wall RV strain (69) (%) | 0.90 | 0.82 | 1.00 | −0.10 | 0.05 | −2.00 | 0.05 |
TAPSE (52) (cm) | 1.47 | 0.43 | 4.96 | 0.38 | 0.62 | 0.62 | 0.54 |
RV/LV ratio in systolic (52) | 1.10 | 0.23 | 5.22 | 0.10 | 0.79 | 0.12 | 0.90 |
RV/LV ratio in diastolic (52) | 0.39 | 0.02 | 6.50 | −0.95 | 1.44 | −0.66 | 0.51 |
RV Tei index (59) | 0.00 | 0.00 | 0.34 | −7.00 | 3.02 | −2.32 | 0.02 |
RVFAC (67) | 1.05 | 1.00 | 1.12 | 0.05 | 0.03 | 1.81 | 0.07 |
PAAT (64) (ms × 10) | 1.07 | 0.89 | 1.30 | 0.07 | 0.10 | 0.72 | 0.47 |
PESI class 3 (69) | 0.13 | 0.01 | 1.61 | −2.05 | 1.29 | −1.59 | 0.11 |
PESI class 4 (69) | 0.08 | 0.01 | 0.73 | −2.56 | 1.15 | −2.23 | 0.03 |
PESI class 5 (69) | 0.02 | 0.00 | 0.23 | −3.84 | 1.20 | −3.19 | <0.01 |
OR | 2.5 % | 97.5 % | Estimate | SE | Z | p-value | |
---|---|---|---|---|---|---|---|
Global RVLS model | |||||||
Age | 0.99 | 0.95 | 1.02 | −0.01 | 0.02 | −0.74 | 0.46 |
Female Gender | 1.20 | 0.32 | 4.58 | 0.18 | 0.68 | 0.27 | 0.79 |
Systolic Blood Pressure | 1.01 | 0.99 | 1.04 | 0.01 | 0.01 | 0.97 | 0.33 |
Global RVLS | 0.87 | 0.77 | 1.00 | −0.14 | 0.07 | −2.01 | 0.04 |
Free wall RVLS model | |||||||
Age | 0.99 | 0.95 | 1.03 | −0.01 | 0.02 | −0.68 | 0.50 |
Female Gender | 1.21 | 0.32 | 4.61 | 0.19 | 0.68 | 0.28 | 0.78 |
Systolic Blood Pressure | 1.01 | 0.98 | 1.04 | 0.01 | 0.01 | 0.67 | 0.50 |
Free wall RVLS | 0.89 | 0.80 | 1.00 | −0.11 | 0.06 | −1.95 | 0.05 |
RV Tei Index model | |||||||
Age at Diagnosis | 0.99 | 0.95 | 1.03 | −0.01 | 0.02 | −0.53 | 0.60 |
Female Gender | 0.78 | 0.17 | 3.47 | −0.26 | 0.76 | −0.33 | 0.74 |
Systolic Blood Pressure | 1.02 | 0.99 | 1.05 | 0.02 | 0.02 | 1.19 | 0.23 |
RV Tei Index | 0.00 | 0.00 | 0.36 | −7.82 | 3.46 | −2.26 | 0.02 |