Right ventricle dysfunction and pulmonary hypertension in hemodynamically stable pulmonary embolism

Abstract

RVD or PHT are a frequent finding at diagnosis in patients with hemodynamically stable pulmonary embolism and they persist at 6 months in a significant proportion of cases. We have observed a relationship between the persistence of residual vascular obstruction in CTPA and RVD or PHT 6 months after PE.

Subjective assessment of right ventricle enlargement from computed tomography pulmonary angiography images

“…Based on these curves, a cutoff of 1.0 was selected as appropriate to compare the sensitivities and specificities with subjective assessments in this population; this cutoff is consistent with previous literature [10,13,14,22,23]. Table 5 and Fig.…”

“…We applied a 1.0 threshold for objective measurements when compared to visual assessment because it is supported by the data (Fig. 6), is frequently used [10,13,14,22,23], and is readily understood because of its practicality, i.e. the RV is larger than the LV.…”

The efficacy of CT for detection of right ventricular dysfunction in acute pulmonary embolism, and comparison with cardiac biomarkers

“…RVD was regarded as present when at least one of three signs was observed on ECHO: RV hypokinesis (asymmetrical or delayed contraction), systolic paradoxical movement of the septal wall, and/or RV dilation (end-diastolic diameter >30 mm or right/left ventricle diameter ratio >1) [9].…”

Prognostic Value of the Charlson Comorbidity Index in Pulmonary Embolism

“…We wondered whether the results of the authors could be extrapolated to other patient groups. We have previously communicated the results of a prospective, single-center study that assessed the incidence of right ventricle dysfunction and pulmonary hypertension in 103 consecutive patients with a life expectancy of >6 months, who were diagnosed with hemodynamically stable PE by means of computed tomography pulmonary angiography [2]. The study was underpowered to assess short-term outcomes because of a low rate of in-hospital adverse events.…”

“…Patients' characteristics and exclusion criteria have been reported elsewhere [2]. In summary, hemodynamically unstable PE, life expectancy <6 months, and creatinine clearance <35 ml/min were exclusion criteria.…”