| Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism. | |
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MedLine Citation:
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PMID: 18579484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Patients suspected of acute pulmonary embolism (PE) frequently undergo echocardiography as a part of the initial work-up. Prognostic implication of routine echocardiography in patients suspected of PE remain to be established. METHODS AND RESULTS: Transthoracic echocardiography, including tissue Doppler imaging, was performed in 283 consecutive patients referred for ventilation/perfusion scintigraphy (V/Q scan) on suspicion of first non-massive PE. The prognostic information of quantitative measures of right ventricular (RV) size, function, and pressure was assessed. Patients with PE had a follow-up echocardiography after 1 year and changes in the parameters were assessed. Patients with PE and normal V/Q scans had similar age-adjusted 1 year mortality [10 and 12%, NS (not significant)], although patients with indeterminate scans carried a poorer prognosis (16% survival, P=0.0004). Among all patients left ventricular (LV) ejection fraction as well as shortening of the pulmonary artery (PA) acceleration time (a measure of RV after-load) was associated with increased mortality [hazard ratio (HR)=0.84 per 10 ms increase, P<0.0001]. In patients with confirmed PE, the PA acceleration time is predictive of event-free survival (all-cause mortality and heart failure hospitalizations) adjusted for LV ejection fraction, age, and sex (HR=0.78 per 10 ms increase, P=0.04). Measures of regional myocardial function were not related to outcome in this study, regardless of presence of PE. CONCLUSION: PA acceleration time and LV systolic function are independent predictors of mortality in patients suspected of PE, and are independent predictors of event-free survival in patients with confirmed PE. |
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Authors:
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Jesper Kjaergaard; Bente Krogsgaard Schaadt; Jens Otto Lund; Christian Hassager |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-05-25 |
Journal Detail:
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Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 10 ISSN: 1532-2114 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-09 Completed Date: 2009-05-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
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Languages: eng Pagination: 89-95 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. jesper.kjaergaard@rh.regionh.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Analysis of Variance Cohort Studies Echocardiography, Doppler / methods* Electrocardiography / methods Evaluation Studies as Topic Female Humans Male Middle Aged Multivariate Analysis Perfusion Imaging / methods* Probability Prognosis Proportional Hazards Models Pulmonary Embolism / mortality, radionuclide imaging, ultrasonography* Risk Factors Sensitivity and Specificity Severity of Illness Index Survival Rate Ventricular Dysfunction, Right / mortality, radionuclide imaging*, ultrasonography* |
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