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- W4225112572 abstract "Abstract Purpose During acute pulmonary embolism (PE) a compensatory increase in right ventricular (RV) contractility is required to match increased afterload to maintain right ventricular-pulmonary arterial (RV-PA) coupling. The aim of this study was to assess the prognostic utility of RV-PA decoupling in acute PE. Methods We assessed the association between measures of transthoracic echocardiography (TTE)-derived RV-PA coupling including tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and right ventricular fractional area change (FAC)/PASP as well as stroke volume index (SVI)/PASP (a measure of pulmonary artery capacitance) with adverse PE-related events (in-hospital PE-related mortality or cardiopulmonary decompensation) using logistic regression analysis. Results In 820 normotensive patients TTE-derived markers of RV-PA coupling were associated with PE-related adverse events. For each 0.1mm/mmHg decrease in TAPSE/PASP the odds of an adverse event increased by 2.5-fold (adjusted OR (aOR) 2.49, 95% confidence interval (CI) 1.46–4.24, p = 0.001), for every 0.1%/mmHg decrease in FAC/PASP the odds of an adverse event increased by 1.4-fold (aOR 1.42, CI 1.09–1.86, p = 0.010), and for every 0.1mL/mmHg•m 2 decrease in SVI/PASP the odds of an event increased by 2.75-fold (aOR 2.78, CI 1.72–4.50, p < 0.001). In multivariate analysis, TAPSE/PASP and SVI/PASP were independent of other risk stratification methods including computed tomography-derived RVD, the Bova score, and subjective assessment of TTE-derived RVD. Conclusion In patients with normotensive acute PE, TTE-derived measures of RV-PA coupling are strongly associated with adverse in-hospital PE-related events and provide incremental value in the risk assessment beyond computed tomography-derived RVD, the Bova score, or subjective TTE-derived RVD." @default.
- W4225112572 created "2022-05-01" @default.
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- W4225112572 date "2022-04-29" @default.
- W4225112572 modified "2023-09-24" @default.
- W4225112572 title "Ventricular-arterial decoupling is associated with in-hospital adverse events in normotensive pulmonary embolism" @default.
- W4225112572 doi "https://doi.org/10.21203/rs.3.rs-1598950/v1" @default.
- W4225112572 hasPublicationYear "2022" @default.
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