Document Detail

Prognostic value of echocardiography and spiral computed tomography in patients with pulmonary embolism.
MedLine Citation:
PMID:  16093809     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: The identification of patients with pulmonary embolism who are at risk for mortality or severe morbidity in the early observation period is important because these patients may benefit from more aggressive initial treatment such as thrombolysis or catheter removal of the thrombus. Right ventricular dysfunction has been suggested to have a prognostic value for the occurrence of these adverse outcomes. The purpose of this review is to determine the prevalence and prognostic value of right ventricular dysfunction, in particular in normotensive patients with pulmonary embolism. The association between right ventricular dysfunction and outcome of pulmonary embolism was evaluated for studies using echocardiography, spiral computed tomography, or both to detect right ventricular dysfunction. RECENT FINDINGS: Seven studies using echocardiography with a total of 3468 patients and six studies using spiral computed tomography with a total of 868 patients were identified. The prevalence of right ventricular dysfunction with echocardiography in normotensive patients was approximately 30 to 40%, with a positive predictive value for short-term mortality of approximately 5%. These indices could not be calculated for normotensive patients in the studies that used spiral computed tomography. SUMMARY: The studies using echocardiography show that there is an association between right ventricular dysfunction and prognosis of pulmonary embolism in normotensive patients. Whether this is clinically useful in guiding more aggressive therapy remains to be determined, however. Thus far, the results of the studies with spiral computed tomography are too preliminary to enable definite conclusions to be drawn for the normotensive patient group.
Nadine S Gibson; Maaike Sohne; Harry R Buller
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  11     ISSN:  1070-5287     ISO Abbreviation:  Curr Opin Pulm Med     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-11     Completed Date:  2005-11-08     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-4     Citation Subset:  IM    
Department of Vascular Medicine, Academical Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Predictive Value of Tests
Pulmonary Embolism / mortality,  physiopathology*,  radiography,  ultrasonography
Tomography, Spiral Computed*
Ventricular Dysfunction, Right / radiography*,  ultrasonography*

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