BACK TO THE BASICS: RIGHT VENTRICULAR LONGITUDINAL DIMENSION AND MID RIGHT ANDLEFT VENTRICULAR RATIO AS PROGNOSTIC AND DIAGNOSTIC TOOLS IN PATIENTS WITH ACUTEPULMONARY EMBOLISM

Document Type

Article

Publication Title

Journal of the American College of Cardiology

Abstract

Background: Pulmonary embolism (PE) is a thromboembolic disease that usually compromises biventricular function and remodeling. Our aim was to evaluate the diagnostic and prognostic value of left (LV) and right ventricular (RV) dimensions derived from echocardiography in patients with acute PE.

Methods: 365 patients with acute PE (31 massive, 186 submassive and 148 low risk) and transthoracic echocardiogram performed within one day of diagnosis from March 2013 through June 2020 were followed prospectively. Measurements of: LV and RV internal diastolic and systolic dimensions, mid RV/LV ratio and RV longitudinal dimension (RVLD) were obtained. Analyses were performed to evaluate their association with: 1) Massive, Sub massive and Low risk PE categories 2) All-cause mortality up to one year.

Results: Mean age was 64 ± 15 years (41.4% women, 28.2% cancer). Mid RV/LV ratio: was significantly different between all PE categories (p value <0.0001); mean ± SD was 1.15 ± 0.26 for Massive PE, 0.89 ± 0.20 for Sub massive PE and 0.73 ± 0.15 for Low risk PE. AUC for predicting massive PE was 0.87 (95% CI = 0.76 - 0.94) (Figure). RVLD was associated with all-cause mortality at: thirty days, three months, six months and one year (all p value <0.01). RVLD AUC for predicting all-cause mortality was 0.82 (95%CI 0.73 - 0.91) for thirty days and 0.74 (95% CI 0.63 - 0.84) for three months.

Conclusion: In patients with acute PE, easy to perform measurements of RVLD and mid RV/LV ratio are good predictors of all-cause mortality and massive PE.

First Page

1788

Publication Date

5-2021

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