Document Detail


Prognostic importance of quantitative echocardiographic evaluation in patients suspected of first non-massive pulmonary embolism.
MedLine Citation:
PMID:  18579484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jesper Kjaergaard; Bente Krogsgaard Schaadt; Jens Otto Lund; Christian Hassager
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-25
Journal Detail:
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:
Created Date:  2009-01-09     Completed Date:  2009-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  89-95     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Copenhagen University Hospital Gentofte, Copenhagen, Denmark. jesper.kjaergaard@rh.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
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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