Pulmonary embolism: Relation between the degree of right ventricle overload and the extent of perfusion defects

Ribeiro, Ary; Juhlin‐Dannfelt, A.; Brodin, Lars‐Åke; Holmgren, A.; Jorfeldt, L.

doi:10.1016/s0002-8703(98)70048-1

Cited by 56 publications

(32 citation statements)

References 14 publications

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“…Traditionally, the assessment of RV size and systolic function during the course of PE was based on a subjective assessment, commonly categorized as normal, mild, moderate, or severe dilation or dysfunction of this chamber. 31,32 At this time, there are no established criteria for the objective assessment of RV function in patients with acute PE. 25,33 However, TAPSE is progressively filling this gap.…”

Section: Discussionmentioning

confidence: 99%

Right Ventricular Echocardiographic Parameters Are Associated with Mortality after Acute Pulmonary Embolism

Khemasuwan

Yingchoncharoen

Tunsupon

et al. 2015

Journal of the American Society of Echocardiography

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Section: Discussionmentioning

confidence: 99%

Right Ventricular Echocardiographic Parameters Are Associated with Mortality after Acute Pulmonary Embolism

Khemasuwan

Yingchoncharoen

Tunsupon

et al. 2015

Journal of the American Society of Echocardiography

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“…In patients with acute pulmonary embolism risk stratification is important because more aggressive therapies such as thrombolytics, inotropic vasoactive drugs, and embolectomy may improve the outcome in patients at risk for acute RV failure [1][2][3][4][5][6]. In-hospital pulmonary embolism mortality rates range from 1% to > 30%, depending on the clinical and hemodynamic profile of the patients included [3].…”

mentioning

confidence: 99%

Combined utility of brain natriuretic peptide and cardiac troponine T may improve rapid triage and risk stratification in normotensive patients with pulmonary embolism

Tulevski¹,

Wolde²,

Veldhuisen³

et al. 2007

International Journal of Cardiology

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“…Hence, the more patients with extensive disease, the greater the likelihood that the population studied has RVD, a known indicator of an increased risk of recurrent VTE and mortality. [17][18][19][20] Previous studies correlated PE extent to right ventricular enlargement, 21 and to thrombus load on CT with degree of right ventricular enlargement. 22 However, to our knowledge, our study is the first to investigate a correlation between anatomical extent of PE and NT-proBNP levels, and recurrent VTE events.…”

Section: 16mentioning

confidence: 99%

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2018

TH Open

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Pulmonary embolism (PE) studies used direct oral anticoagulants (DOACs) with or without initial heparin. We aimed to (1) evaluate if PE patients benefit from initial heparin; (2) describe patient characteristics in the DOAC studies; and (3) investigate whether the anatomical extent of PE correlates with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, cause of PE, and recurrence rate. Our methods were (1) an indirect meta-analysis comparing the recurrence risk in DOAC-treated patients with or without initial heparin to those patients given heparin/vitamin K antagonist (VKA). (2) To compare the PE studies, information was extracted on baseline characteristics including anatomical extent. (3) The Hokusai-VTE study was used to correlate anatomical extent of PE with NT-proBNP levels, causes of PE, and recurrent venous thromboembolism (VTE). The meta-analysis included 11,539 PE patients. The relative risk of recurrent VTE with DOACs versus heparin/VKAs was 0.8 (95% confidence interval [CI]: 0.6-1.1) with heparin lead-in and 1.1 (95% CI: 0.8-1.5) without heparin. In the DOAC studies, the proportion of patients with extensive PE varied from 24 to 47%. In Hokusai-VTE, NT-proBNP was elevated in 4% of patients with limited and in over 60% of patients with extensive disease. Cause of PE and anatomical extent were not related. Recurrence rates increased from 1.6% with limited to 3.2% with extensive disease in heparin/edoxaban-treated patients, and from 2.4 to 3.9% in heparin/warfarin recipients. In conclusion, indirect evidence suggests a heparin lead-in before DOACs may be advantageous in PE. Anatomical extent was related to elevated NT-proBNP and outcome, but not to PE cause.

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Pulmonary embolism: Relation between the degree of right ventricle overload and the extent of perfusion defects

Cited by 56 publications

References 14 publications

Right Ventricular Echocardiographic Parameters Are Associated with Mortality after Acute Pulmonary Embolism

Right Ventricular Echocardiographic Parameters Are Associated with Mortality after Acute Pulmonary Embolism

Combined utility of brain natriuretic peptide and cardiac troponine T may improve rapid triage and risk stratification in normotensive patients with pulmonary embolism

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