Recovery of right ventricular function after intermediate-risk pulmonary embolism: results from the multicentre Pulmonary Embolism International Trial (PEITHO)-2
| Autor: | Mavromanoli, A.C., Barco, S., Ageno, W., Bouvaist, H., Brodmann, M., Cuccia, C., Couturaud, F., Dellas, C., Dimopoulos, K., Duerschmied, D., Empen, K., Faggiano, P., Ferrari, E., Galie, N., Galvani, M., Ghuysen, A., Giannakoulas, G., Huisman, M.V., Jimenez, D., Kozak, M., Lang, I.M., Meneveau, N., Munzel, T., Palazzini, M., Petris, A.O., Piovaccari, G., Salvi, A., Schellong, S., Schmidt, K.H., Verschuren, F., Schmidtmann, I., Toenges, G., Klok, F.A., Konstantinides, S.V., PEITHO-2 Investigators |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
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 |
| Zdroj: | Clinical Research in Cardiology. SPRINGER HEIDELBERG Clinical Research in Cardiology |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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