Author + information
- Aditya Sood,
- Arshad Javed,
- Mobeen Rehman,
- Kartik Kumar,
- Manmohan Singh,
- Emmanuel Akintoye,
- Mohan Palla and
- Luis Afonso
Background: The contemporary role of echocardiography in the diagnostic algorithm for acute pulmonary embolism (APE) is largely supportive. This pilot study explored the utility of novel echocardiographic variables for the diagnosis of APE.
Methods: A retrospective analysis of massive/sub-massive APE patients confirmed by CT-thorax. We analyzed morphologic and echo Doppler hemodynamic variables including RVOT acceleration time, RVOT deceleration-acceleration time (D/A) ratio, early systolic notching (RVOT PW Doppler) and McConnell's sign. Bivariate analysis, diagnostic accuracy and ROC analyses were performed.
Results: A total of 46 subjects; 30 with APE (4 massive and 26 sub-massive) and 16 without APE were studied. Mean age was 54.9 (± 12.8) years. Expectedly, significant differences in in acceleration time, D/A ratio, early systolic notching and McConnell's sign were noted in subjects with and without PE (Table 1). Sensitivities and specificities of acceleration time (cutoff ≤ 93.14 ms; AUC 0.973, p=0.000) were 93% and 94%, D/A ratio (cutoff ≥2.04; AUC 0.983, p=0.000) were 93% and 94%, early systolic notching (AUC 0.933, p=0.000) were 86.67% and 100% and McConnell's sign (AUC 0.767, p=0.003) were 53.33% and 100% respectively.
Conclusions: Acceleration time, D/A ratio, and early systolic notching emerged as the strongest predictors of massive and sub massive APE. Further studies with larger sample size are warranted to validate these findings.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Insights From Echocardiography Use
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1291-233
- 2017 American College of Cardiology Foundation