Author + information
- Brett Carroll,
- Dominique DaBreo,
- Jason Matos,
- Benedikt Heidinger,
- Donya Mohebali,
- Stephanie Feldman,
- Ian McCormick,
- Diana Litmanovich and
- Warren Manning
Introduction: Evidence of right ventricular strain (RVS) on either transthoracic echocardiography (TTE), computed tomography (CT), or electrocardiography (ECG) has been shown to increase the risk of adverse outcomes in patients with acute pulmonary embolism (APE). We evaluated the combined predictive value of RVS in these three modalities in the same cohort of patients.
Methods: We retrospectively identified consecutive patients hospitalized with APE diagnosed by CT from May 2007 through December 2014. Patients were included if they had an ECG and TTE performed 24 hours prior to or 48 hours after CT was obtained. Each modality was independently reviewed for evidence of RVS. Adverse outcomes included administration of thrombolytic therapy or vasopressors, embolectomy, and/or death related to APE within 30 days of diagnosis. Logistic regression was performed using Stata 14.1.
Results: Four hundred and six patients are included in the analysis with mean age of 63±16 years and 54% female. An adverse outcome occurred in 50 patients. The rate of adverse outcome was low if no evidence of RVS was present (see table). Odds ratio of an adverse outcome when adjusting for age and sex increased with RVS on CT or TTE. Risk was higher if RVS was present on both CT and TTE. Odds did not further increase if RVS on ECG was added to a positive CT and TTE.
Conclusions: In patients with APE, there is additive predictive value of assessing RVS by both CT and TTE; however, ECG does not appear to be of additional predictive value.
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: 1141-006
- 2017 American College of Cardiology Foundation