Document Detail


Clinical, historical and diagnostic findings associated with right ventricular dysfunction in patients with central and non-massive pulmonary embolism.
MedLine Citation:
PMID:  19937481     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Right ventricular dysfunction during acute pulmonary embolism (PE) predisposes to hemodynamic instability and cardiogenic shock. Aim of this case-control study was to determine the clinical, historical and diagnostic findings associated with right ventricular dysfunction in patients with acute PE involving the main or segmental pulmonary arteries (central PE) and without hemodynamic instability on admission to the Emergency Department (ED) (non-massive PE). From January 1, 2002 to December 31, 2005, 211 patients with central PE were admitted to the Department of Emergency Medicine of the "Antonio Cardarelli" Hospital (Naples, Italy). One hundred eighteen of them had echocardiographic evidence of right ventricular dysfunction on admission to the ED. A history of type 2 diabetes mellitus and chronic obstructive pulmonary disease were significantly associated with an increased risk of this PE-related complication. Compared to patients without right ventricular dysfunction, those with right ventricular dysfunction showed higher levels of markers of cardiac damage, and a significant impairment of respiratory function. Echocardiographic evidence of right ventricular dysfunction on admission to the ED was significantly associated with the occurrence of hemodynamic instability and cardiogenic shock during the PE clinical course. The study results indicate that a history of type 2 diabetes mellitus and chronic obstructive pulmonary disease are significantly associated with the occurrence of right ventricular dysfunction in patients with non-massive and central PE independent of age, gender and other historical and clinical variables detectable on admission to the ED.
Authors:
Domenico Rendina; Silvana De Bonis; Giovanni Gallotta; Vincenzo Piedimonte; Giuseppe Mossetti; Gianpaolo De Filippo; Francesca Farina; Giuseppe Vargas; Maria Rosaria Barbella; Alfredo Postiglione; Pasquale Strazzullo
Publication Detail:
Type:  Journal Article     Date:  2009-11-25
Journal Detail:
Title:  Internal and emergency medicine     Volume:  5     ISSN:  1970-9366     ISO Abbreviation:  Intern Emerg Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-05-24     Revised Date:  2010-09-23    
Medline Journal Info:
Nlm Unique ID:  101263418     Medline TA:  Intern Emerg Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  53-9     Citation Subset:  IM    
Affiliation:
Department of Clinical and Experimental Medicine, Federico II University Medical School, via S. Pansini, 5, 80131, Naples, Italy. domenico.rendina@unina.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Diabetes Mellitus, Type 2 / complications
Disease Progression
Echocardiography
Female
Humans
Male
Middle Aged
Odds Ratio
Pulmonary Disease, Chronic Obstructive / complications
Pulmonary Embolism / complications,  physiopathology*,  radiography*
Retrospective Studies
Risk Factors
Shock, Cardiogenic / etiology,  physiopathology*
Tomography, Spiral Computed
Ventricular Dysfunction, Right / etiology,  physiopathology*,  ultrasonography
Comments/Corrections
Comment In:
Intern Emerg Med. 2010 Oct;5(5):451-2   [PMID:  20645134 ]

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