Right ventricular stroke distance predicts death and clinical deterioration in patients with pulmonary embolism.

Abstract:

PURPOSE:The right ventricular outflow tract (RVOT) velocity time integral (VTI), an echocardiographic measure of stroke distance, correlates with cardiac index. We sought to determine the prognostic significance of low RVOT VTI on clinical outcomes among patients with acute pulmonary embolism (PE). MATERIALS AND METHODS:We conducted a retrospective review of echocardiograms on Pulmonary Embolism Response Team (PERT) activations at our institution. The main outcome was a composite of death, cardiac arrest, or hemodynamic deterioration. RESULTS:Of 188 patients, 30 met the combined outcome (16%) and had significantly lower RVOT VTI measurements (9.0 cm v 13.4 cm, p < 0.0001). The AUC for RVOT VTI at a cutoff of 10 cm was 0.78 (95% CI 0.67-0.90) with a sensitivity, specificity, negative predictive value, and positive predictive value of 0.72, 0.81, 0.94, and 0.42, respectively. Fifty-two patients of the cohort were classified as intermediate-high-risk PE and 21% of those met the combined outcome. RVOT VTI was lower among outcome positive patients (7.3 cm v 10.7 cm, p = 0.02). CONCLUSIONS:Low RVOT VTI is associated with poor clinical outcomes among patients with acute PE.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Yuriditsky E,Mitchell OJL,Sista AK,Xia Y,Sibley RA,Zhong J,Moore WH,Amoroso NE,Goldenberg RM,Smith DE,Brosnahan SB,Jamin C,Maldonado TS,Horowitz JM

doi

10.1016/j.thromres.2020.06.049

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

29-34

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(20)30291-7

journal_volume

195

pub_type

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