| Prognostic significance of right ventricular hypokinesis and perfusion lung scan defects in pulmonary embolism. | |
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MedLine Citation:
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PMID: 8172067 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We studied the relation between right ventricular (RV) hypokinesis on echocardiography and defects on the initial perfusion lung scan among 90 hemodynamically stable patients with pulmonary embolism (PE). Of the 90, 38 had qualitative evidence of RV hypokinesis, with a mean RV end-diastolic area significantly larger than those with normal RV wall motion (40.0 +/- 10.2 cm2 vs 20.1 +/- 6.4 cm2; p < 0.001). The degree of the perfusion defect was greater in those patients with baseline RV hypokinesis (54% +/- 16% of the lung nonperfused) than in those patients with normal RV wall motion at baseline (30% +/- 18% nonperfused lung; p < 0.001). Receiver operating characteristic curve analysis showed that a perfusion lung scan defect score of 0.3 (i.e., 30% of the lung nonperfused) had a 92% sensitivity for predicting RV hypokinesis and carried a relative risk for observing RV hypokinesis of 6.8 times greater than among those patients with a perfusion scan score of < 0.3. Considering that all patients with recurrent symptomatic PE were in the subgroup with RV hypokinesis (13% vs 0% for those with normal RV wall motion; p = 0.01), a strategy of performing echocardiography in those patients with a perfusion scan defect score of > or = 0.3 appears to identify patients at increased risk for recurrent PE. |
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Authors:
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M W Wolfe; R T Lee; M L Feldstein; J A Parker; P C Come; S Z Goldhaber |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: American heart journal Volume: 127 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1994 May |
Date Detail:
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Created Date: 1994-06-02 Completed Date: 1994-06-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1371-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Chi-Square Distribution Echocardiography / methods, statistics & numerical data False Positive Reactions Humans Lung / blood supply*, ultrasonography Prognosis Pulmonary Embolism / epidemiology, physiopathology*, ultrasonography ROC Curve Random Allocation Thorax Time Factors Ventricular Function, Right / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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