Document Detail

Central thromboembolism is a possible predictor of right heart dysfunction in normotensive patients with acute pulmonary embolism.
MedLine Citation:
PMID:  20638710     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Right heart dysfunction is a crucial factor in risk stratification of normotensive patients with pulmonary embolism. Apart from biomarkers, determinants of right heart dysfunction in this group of patients are not yet well established.
AIM AND METHOD: In order to identify such determinants, we analysed data of 252 patients with acute pulmonary embolism admitted to our hospital in 2008.
RESULTS: 69 out of 140 patients showed right heart dysfunction by echocardiography within 24 hours after diagnosis, 71 did not. Right ventricular dysfunction was significantly more frequent in patients with central clots on computed tomography (p=0.004), a history of syncope (p<0.001) and among women on oral contraceptives (p=0.003). In multiple regression analysis, only central thromboembolism (p<0.001) was identified as individual predictor of right ventricular dysfunction. Age, gender, body mass index, idiopathic or recurrent thromboembolism, duration of symptoms, preceding surgery, room air oxygen saturation, carcinoma, hypertension, diabetes, renal disease, congestive left heart failure and concomitant lung disease were equally distributed. In comparison with NT-pro brain natriuretic peptide (PPV 67%, NPV 75%, p=0.782) and troponin I (PPV 76%, NPV 62%, p=0.336), central thromboembolism has shown to have a greater statistical power in predicting right heart dysfunction in normotensive patients with pulmonary embolism (PPV 78%, NPV 88%, p<0.001).
CONCLUSION: Among normotensive patients with acute pulmonary embolism, those with central clots seem to be at greater risk for echocardiographically evaluated right ventricular dysfunction.
T M Berghaus; T Haeckel; W Behr; M Wehler; W von Scheidt; M Schwaiblmair
Publication Detail:
Type:  Journal Article     Date:  2010-07-17
Journal Detail:
Title:  Thrombosis research     Volume:  126     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-28     Revised Date:  2011-05-02    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e201-5     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Ltd. All rights reserved.
Department of Cardiology, Pneumology, Intensive Care and Endocrinology, Klinikum Augsburg, Germany.
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MeSH Terms
Acute Disease
Aged, 80 and over
Chi-Square Distribution
Contraceptives, Oral / adverse effects
Linear Models
Middle Aged
Pulmonary Embolism / complications*,  radiography
Risk Assessment
Risk Factors
Sex Factors
Syncope / complications
Thromboembolism / complications*,  radiography
Tomography, X-Ray Computed
Ventricular Dysfunction, Right / etiology*,  ultrasonography
Reg. No./Substance:
0/Contraceptives, Oral
Comment In:
Thromb Res. 2011 Apr;127(4):386   [PMID:  21146200 ]

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