Author + information
- Elie Dan Schouver,
- Olivier Chiche,
- Priscille Bouvier,
- Denis Doyen,
- Pierre Cerboni,
- Pamela Moceri,
- Emile Ferrari and
- Chu Pasteur
Background: The benefit of volume expansion (VE) in submassive pulmonary embolism (PE) with right ventricular dysfunction (RVD) is unclear. We sought to compare the effects of a diuretic treatment versus fluid expansion in patients hospitalized for PE with RVD.
Methods: We prospectively included 46 consecutive patients with submassive PE with RVD treated on admission with a bolus of 40 mg of furosemide (D group, n=24) or with 500 cc of saline infusion (VE group, n=22). Primary endpoint was the timing for normalization of Brain Natriuretic Peptide (BNP) and Troponin Ic values. Secondary endpoints were comparison of clinical and echographic parameters recorded at baseline, at the 4th hour (H4) and every day until discharge, and a clinical composite endpoint of thrombolysis and death at 7 and 30 days.
Results: No differences were observed between patients at baseline. Primary endpoint occurred earlier in the D group than in the VE group (67.5±34.8 vs 111.6±63.3 hours, p=0.006). Furosemide treatment on admission was well tolerated and not associated with serious adverse events. At H4, substantial heart rate reduction and tricuspid annular peak systolic velocity (assessed by Doppler tissue imaging) improvement were observed in D versus VE patients with respectively -8.15±21.0 vs -0.71±6.30 bpm, p<0.01 and 11.4±2.10 vs 9.90±2.80 cm/s, p=0.02. There was no significant difference in term of severe outcomes between the two groups at 7 and 30 days.
Conclusions: In comparison to VE, one single bolus of 40 mg of furosemide might improve early clinical, biological and echocardiographic severity markers in patients with acute submassive PE without serious adverse effects.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Updates on Pulmonary Embolism Management in 2017
Abstract Category: 35. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease
Presentation Number: 1141-003
- 2017 American College of Cardiology Foundation