Pulmonary embolism: echocardiographic particularities in acute phase and distance monitoring.
The early use of echocardiography predicts short-term adverse outcomes in acute pulmonary embolism
Keywords:heart failure, fragility, Edmonton score
Pulmonary thromboembolism (PE) remains a fatal disease underdiagnosed in the emergency department that suggests the need for alternative noninvasive approaches to rapid diagnosis. The role of echocardiography (ETT) in acute pulmonary embolism (PE) remains incompletely defined. Of the 80 patients included in the study with the preventive diagnosis of PET 68 (85%) underwent ETT examination in the first 24-48 hours of hospitalization. ETT analysis established signs of pulmonary hipertension: severe (PSAP ≥55mmHg) at 39 pts (57.3%), moderate (PSAP ≥35<55mmHg) at 25 pts (36.7%); low (PSAP <35mmHg) at 4 pts (5.9%). RV dilatation>35mm, RA area> 18.0cm2, RV free wall hypokinesis, reduction of TAPSE index <16.0mm, increase of tricuspid regurgitation jet speed> 2.8 m/sec, decrease of RV S’m tissue index <9, 5cm/sec, TAPSE / PASP ratio <0.4 and combinations thereof demonstrated superiority in predicting adverse outcome in high and intermediate risk in acute PE. This article is part of the results of the study within the state project with the figure 20.80009.8007.28.
Howard L. Embolie pulmonară acută. Clin. Med. (Lond), 2019,5; 19 (3), 243–247.
Konstantinides S., Meyer G. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society. European Heart Journal.2020, 41, 603-649.
HabibG., Torbicki A. The role of echocardiography in the diagnosis and management of patients with pulmonary hypertension. Eur Respir Rev., 2010; 19: 118, 288–299
Wolde M, Seohne M.,et al. Prognostic Value of Echocardiographically Assessed Right Ventricular Dysfunction in Patients With Pulmonary Embolism. Arch Intern Med. 2004;164:1685-1689
Bikdeli B., Lobo J. , Jiménez D. et al. Early Use of Echocardiography in Patients With Acute Pulmonary Embolism: Findings From the RIETE Registry. JAHA, 2018;7:142-152.
Matei R., Manițiu I. Rolul investigațiilor imagistice în managementul trombembolismului pulmonar. Acta Medica Transilvanică, 2013, II, 4,154-156.
Lyhne M., Kabrhel C., Giordano N., Andersen A., Nielsen-Kudsk J., Zheng H., Dudzinski D. The echocardiographic ratio tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure predicts shortterm adverse outcomes in acute pulmonary embolism. European Heart Journal Cardiovascular Imaging. 2020, 22, 3, 285–294.
Corciovă F., Arsenescu – Georgescu C. Evaluarea ecocardiografică a hipertensiunii pulmonare – corelaţii cu parametrii hemodinamici. Revista Societatii de Medicina Interna, 2012,5; 34-39.
Brierre G., Blot-Souletie N., Degano B., Tetu L., Bongard V., Carrie D. New echocardiographic prognostic factors for mortality in pulmonary arterial hypertension. European Journal of Echocardiography. 2010,11, 6, 516–522.
Meneveau N., Ider O., Seronde M, Chopard R., et al. Long-term prognostic value of residual pulmonary vascular obstruction at discharge in patients with intermediateto high-risk pulmonary embolism. European Heart Journal. 2013; 34, 693–701.
Guizzi M., Bandera F., Pelissero G., et al. Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis. Am J Phisiol Heart Circ Physiol. 2013; 305:H1373-81.
Copyright (c) 2022 Bulletin of the Academy of Sciences of Moldova. Medical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.