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SHR Neuro Cancer Cardio Lipid Metab Microb
Mavromanoli, AC; Barco, S; Ageno, W; Bouvaist, H; Brodmann, M; Cuccia, C; Couturaud, F; Dellas, C; Dimopoulos, K; Duerschmied, D; Empen, K; Faggiano, P; Ferrari, E; Galie, N; Galvani, M; Ghuysen, A; Giannakoulas, G; Huisman, MV; Jimenez, D; Kozak, M; Lang, IM; Meneveau, N; Munzel, T; Palazzini, M; Petris, AO; Piovaccari, G; Salvi, A; Schellong, S; Schmidt, KH; Verschuren, F; Schmidtmann, I; Toenges, G; Klok, FA; Konstantinides, SV.
Recovery of right ventricular function after intermediate-risk pulmonary embolism: results from the multicentre Pulmonary Embolism International Trial (PEITHO)-2
CLIN RES CARDIOL. 2023;
Doi: 10.1007/s00392-022-02138-4
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- Co-authors Med Uni Graz
- Brodmann Marianne
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- Abstract:
- BackgroundRight ventricular (RV) function plays a critical role in the pathophysiology and acute prognosis of pulmonary embolism (PE). We analyzed the temporal changes of RV function in the cohort of a prospective multicentre study investigating if an early switch to oral anticoagulation in patients with intermediate-risk PE is effective and safe. MethodsEchocardiographic and laboratory examinations were performed at baseline (PE diagnosis), 6 days and 6 months. Echocardiographic parameters were classified into categories representing RV size, RV free wall/tricuspid annulus motion, RV pressure overload and right atrial (RA)/central venous pressure. ResultsRV dysfunction based on any abnormal echocardiographic parameter was present in 84% of patients at baseline. RV dilatation was the most frequently abnormal finding (40.6%), followed by increased RA/central venous pressure (34.6%), RV pressure overload (32.1%), and reduced RV free wall/tricuspid annulus motion (20.9%). As early as day 6, RV size remained normal or improved in 260 patients (64.7%), RV free wall/tricuspid annulus motion in 301 (74.9%), RV pressure overload in 297 (73.9%), and RA/central venous pressure in 254 (63.2%). At day 180, the frequencies slightly increased. The median NT-proBNP level decreased from 1448 pg/ml at baseline to 256.5 on day 6 and 127 on day 180. ConclusionIn the majority of patients with acute intermediate-risk PE switched early to a direct oral anticoagulant, echocardiographic parameters of RV function normalised within 6 days and remained normal throughout the first 6 months. Almost one in four patients, however, continued to have evidence of RV dysfunction over the long term.
- Find related publications in this database (Keywords)
- Echocardiography
- Right ventricle
- Dysfunction
- Pulmonary embolism
- Intermediate-risk