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Recovery of right ventricular function after intermediate-risk pulmonary embolism: results from the multicentre Pulmonary Embolism International Trial (PEITHO)-2
- Source :
- Clinical Research in Cardiology. SPRINGER HEIDELBERG, Clinical Research in Cardiology
- Publication Year :
- 2022
- Publisher :
- SPRINGER HEIDELBERG, 2022.
-
Abstract
- Background Right 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. Methods Echocardiographic 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. Results RV 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. Conclusion In 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. Graphical Abstract
- Subjects :
- Science & Technology
Cardiac & Cardiovascular Systems
Pulmonary embolism
WORKING GROUP
General Medicine
ASSOCIATION
GUIDELINES
EUROPEAN-SOCIETY
DYSFUNCTION
Echocardiography
Dysfunction
Cardiovascular System & Cardiology
MANAGEMENT
HEART
Right ventricle
Intermediate-risk
Cardiology and Cardiovascular Medicine
FOLLOW-UP
Life Sciences & Biomedicine
CARDIOLOGY
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Clinical Research in Cardiology. SPRINGER HEIDELBERG, Clinical Research in Cardiology
- Accession number :
- edsair.doi.dedup.....71e206442b03b1304490d23485445fc9