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Erschienen in: Heart and Vessels 7/2019

22.01.2019 | Original Article

Prognostic value of echocardiographic parameters for right ventricular function in patients with acute non-massive pulmonary embolism

verfasst von: Kyusup Lee, Osung Kwon, Eun-Jeong Lee, Min-Jung Sin, Jae Seung Lee, Sahmin Lee, Duk-Hyun Kang, Jae-Kwan Song, Jong-Min Song

Erschienen in: Heart and Vessels | Ausgabe 7/2019

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Abstract

A prognostic value of right ventricular (RV) systolic function assessed by echocardiography in patients with acute non-massive pulmonary embolism (PE) remains controversial. The hypothesis was RV free wall strain measured using speckle-tracking echocardiography might be a powerful prognostic factor in those patients. We aimed to evaluate the prognostic value of echocardiographic measurements of RV systolic function for clinical outcomes and to assess the correlation between the echocardiographic RV function parameters in patients with acute non-massive PE. Between November 2013 and September 2016, 144 consecutive patients diagnosed as acute non-massive pulmonary embolism were prospectively enrolled and echocardiographic evaluations were performed within 1 week of diagnosis to measure various parameters of RV systolic function. The primary endpoint was in-hospital events, the composite of in-hospital PE-related death, need of additive treatments such as thrombolysis or pulmonary artery thromboembolectomy, and need of inotropics due to unstable vital sign. Among patients (mean age 60.3 ± 14.7 years, 50% female) with acute non-massive PE, the in-hospital event rate was 11.1% (16 of 144 patients). In multivariate logistic regression analysis, after adjustment of confounding factors such as age, gender, and diabetes mellitus, RV free wall strain [odd ratio (OR) 1.12, 95% confidence interval (CI) 1.04–1.21, p = 0.002] and RV global wall strain (OR 1.20, 95% CI 1.07–1.35, p = 0.002) were independent predictors for in-hospital events. The event rates were significantly different between groups classified based on RV free wall strain with cut-off value of − 15.85% (p < 0.001). RV strain assessed with speckle-tracking echocardiography is an independent prognostic marker for in-hospital events in patients with acute non-massive PE. Our results may help identify high–intermediate risk patients who need a closer monitoring.
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Metadaten
Titel
Prognostic value of echocardiographic parameters for right ventricular function in patients with acute non-massive pulmonary embolism
verfasst von
Kyusup Lee
Osung Kwon
Eun-Jeong Lee
Min-Jung Sin
Jae Seung Lee
Sahmin Lee
Duk-Hyun Kang
Jae-Kwan Song
Jong-Min Song
Publikationsdatum
22.01.2019
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 7/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-019-01340-1

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