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Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism

5Citations signalées — pas une note de qualité
18Institutions déclarées
3Pays d’affiliation déclarés

Résumé fourni par la source

AIMS: Acute pulmonary embolism (PE) increases pulmonary pressure and impair right ventricular (RV) function. Echocardiographic investigation can quantify this mismatch as the tricuspid annular plane systolic excursion (TAPSE) to pulmonary arterial systolic pressure (PASP) ratio. The aim of the study was to investigate the prognostic capabilities of TAPSE/PASP ratio in patients with acute PE. METHODS AND RESULTS: We utilized the Registro Informatizado Enfermedad TromboEmbolica registry to analyse consecutive haemodynamically stable PE patients. We used multi-variable logistic regression analyses to assess the association between the TAPSE/PASP ratio and 30-day all-cause mortality across the strata of European Society of Cardiology (ESC) risk categories. We included 4478 patients, of whom 1326 (30%) had low-risk, 2425 (54%) intermediate-low risk and 727 (16%) intermediate-high risk PE. Thirty-day mortality rates were 0.7%, 2.3% and 3.4%, respectively. Mean TAPSE/PASP ratio was 0.65 ± 0.29 in low-risk patients, 0.46 ± 0.30 in intermediate-low risk and 0.33 ± 0.19 in intermediate-high risk patients. In multi-variable analyses, there was an inverse association between TAPSE/PASP ratio and 30-day mortality (adjusted OR 1.32 [95% CI 1.14-1.52] per 0.1 decrease in TAPSE/PASP). TAPSE/PASP ratio below optimal cut-points was associated with increased mortality in low- (<0.40, aOR: 5.88; 95% CI: 1.63-21.2), intermediate-low (<0.43, aOR: 2.96; 95% CI: 1.54-5.71) and intermediate-high risk patients (<0.34, aOR: 4.37; 95% CI: 1.27-15.0). TAPSE/PASP <0.44 showed net reclassification improvement of 18.2% (95% CI: 0.61-35.8) vs. RV/LV ratio >1, and 27.7% (95% CI: 10.2-45.1) vs. ESC risk strata. CONCLUSION: Decreased TAPSE/PASP ratio was associated with increased mortality. The ratio may aid in clinical decision-making, particularly for intermediate-risk patients for whom the discriminatory capability of the current risk stratification tools is limited.

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Contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref
Right ventricular-pulmonary artery coupling for prognostication in acute pulmonary embolism
Date Crossref
24/10/2024
Éditeur
Oxford University Press (OUP)
Type
journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude et ne compte pas comme une seconde source scientifique indépendante.

Institutions déclarées

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Sujets associés

Pulmonary Hypertension Research and TreatmentsVenous Thromboembolism Diagnosis and ManagementCardiovascular Function and Risk Factors

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