The 68th Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Longitudinal echocardiographic follow-up of patients with acute PE and right ventricular dysfunction

Rami Gilead 1,2 Shahar Dekel 1,2 Dor Lotan 1,2 Fernando Chernomordik 1,2 Israel Mazin 1,2 Ori Vatury 1,2 Nir Shlomo 1,2 Avishay Grupper 1,2 Shlomi Matetzky 1,2 Roy Beigel 1,2
1The Cardiovascular Division, The Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel
2Sackler School of Medicine, Tel Aviv University, Israel

Introduction:
Right Ventricular (RV) involvement is a major criterion for grading of PE severity and has been proven to be a major prognostic factor. However, the long-term echocardiographic and clinical course of PE patients, who were initially diagnosed with RV dysfunction has not been thoroughly studied. The aim of our study was to examine the echocardiographic course of patients who were diagnosed with acute PE and RV dysfunction by performing serial echocardiographic studies during their initial hospitalization stay and during a long-term follow-up for up to 1 year.

Methods:
The study included acute PE patients enrolled prospectively and hospitalized at a single tertiary medical center with a diagnosis of acute PE and RV dysfunction on their initial echocardiographic exam. RV function was further assessed by follow-up echocardiographic exams during the index hospitalization and during follow-up of 6-12 months.

Results:
Overall, we evaluated 87 consecutive patients with a confirmed diagnosis of PE and evidence of RV dysfunction on their initial echocardiographic exam (mean age 67±15, 58% females). RV dysfunction was classified as mild, moderate, and severe in 15(17%), 31(36%) and 41(47%) patients, respectively. 5 patients died during hospitalization. 68(78%) patients were treated solely with anticoagulants, 8(9%) received TPA, 5(6%) were treated with catheter thrombolysis and 6(7%) were surgically treated. Prior to discharge, 55 patients (63%) showed improvement in RV function by at least 1 grade upon a follow-up echo exam. Echocardiographic follow-up at 6-12 months was available for 55 patients of which 48 had normal RV function. In a multivariate analysis, malignancy was found to be a predictor for lack of improvement in RV function upon discharge (OR 2.7, 95%CI 1-7.1, p=0.04).

Conclusion:
The majority of PE patients presenting with evidence of RV dysfunction show improvement during hospitalization and within 6-12 of follow-up.









Powered by Eventact EMS