Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism.

Details

Serval ID
serval:BIB_7EC8B87A0552
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Echocardiography does not predict mortality in hemodynamically stable elderly patients with acute pulmonary embolism.
Journal
Thrombosis research
Author(s)
Hofmann E., Limacher A., Méan M., Kucher N., Righini M., Frauchiger B., Beer J.H., Osterwalder J., Aschwanden M., Matter C.M., Banyai M., Egloff M., Hugli O., Staub D., Bounameaux H., Rodondi N., Aujesky D.
ISSN
1879-2472 (Electronic)
ISSN-L
0049-3848
Publication state
Published
Issued date
09/2016
Peer-reviewed
Oui
Volume
145
Pages
67-71
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
The evidence on the prognostic value of transthoracic echocardiography (TTE) in elderly, hemodynamically stable patients with Pulmonary Embolism (PE) is limited.
To evaluate the prevalence of common echocardiographic signs of right ventricular (RV) dysfunction and their prognostic impact in hemodynamically stable patients aged ≥65years with acute PE in a prospective multicenter cohort.
TTE was performed by cardiologists. We defined RV dysfunction as a RV/left ventricular ratio >0.9 or RV hypokinesis (primary definition) or the presence of ≥1 or ≥2 of 6 predefined echocardiographic signs (secondary definitions). Outcomes were overall mortality and mortality/non-fatal recurrent venous thromboembolism (VTE) at 30days, adjusting for the Pulmonary Embolism Severity Index risk score and highly sensitive troponin T values.
Of 400 patients, 36% had RV dysfunction based on our primary definition, and 81% (≥1 sign) and 53% (≥2 signs) based on our secondary definitions, respectively. Using our primary definition, there was no association between RV dysfunction and mortality (adjusted HR 0.90, 95% CI 0.31-2.58) and mortality/non-fatal VTE (adjusted HR 1.09, 95% CI 0.40-2.98). Similarly, there was no statistically significant association between the presence of ≥1 or ≥2 echocardiographic signs (secondary definitions) and clinical outcomes.
The prevalence of echocardiographic RV dysfunction varied widely depending upon the definition used. There was no association between RV dysfunction and clinical outcomes. Thus, TTE may not be suitable as a stand-alone risk assessment tool in elderly patients with acute PE.
http://clinicaltrials.gov. Identifier: NCT00973596.

Keywords
Aged, Aged, 80 and over, Cohort Studies, Echocardiography/methods, Female, Humans, Male, Prospective Studies, Pulmonary Embolism/diagnostic imaging, Pulmonary Embolism/mortality, Treatment Outcome
Pubmed
Create date
13/02/2017 15:58
Last modification date
16/10/2019 17:16
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