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Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism
Background Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pul...
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| Published in: | The Egyptian Journal of Bronchology 2023-12, Vol.17 (1), p.6-7, Article 6 |
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| container_title | The Egyptian Journal of Bronchology |
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| creator | El-Morshedy, Reham M. El-kholy, Maha M. Hamad, Dina A. El-Sokkary, Rofaida R. Mohamed, Marwan N. |
| description | Background
Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE).
Results
The studied cases were subdivided into two classes:
Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (
p
< 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (
p
< 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (
p |
| doi_str_mv | 10.1186/s43168-023-00181-x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_3fff67307c1b40a1937ca7f6fae36c7c</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_3fff67307c1b40a1937ca7f6fae36c7c</doaj_id><sourcerecordid>2766938524</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-d04a6a1e0a329ab47d58f0d4909aac4d8e44b66d734879b18286b37b4755e67a3</originalsourceid><addsrcrecordid>eNp9kctOwzAQRSMEElXpD7CKxDpgx47tLFHFo1IlWMDamvjRuiRxsVNU_h63QcCKjcfynHs9o5tllxhdYyzYTaQEM1GgkhQIYYGL_Uk2KQmmhagqfPrnfp7NYtygRFUMCcwnWfsc_Kr3cXAq_4B2Z3Jvc6PWXkHQzq8CbNep5XrtlImp5sHFtzwOAQZnnUqn7w8a1w8mdEY7GExxZLa7tvM9hM_cdI1vXewusjMLbTSz7zrNXu_vXuaPxfLpYTG_XRaKVnwoNKLAABsEpKyhoVxXwiJNa1QDKKqFobRhTHNCBa8bLErBGsITWFWGcSDTbDH6ag8buQ2uS1NID04eH3xYSQhp49ZIYq1lnCCucEMR4JpwBdwyC4YwxVXyuhq9tsG_70wc5MbvQp_GlyVnrCaiKmmiypFSwccYjP35FSN5CEmOIckUkjyGJPdJREZRTHC_MuHX-h_VF-UJlwM</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2766938524</pqid></control><display><type>article</type><title>Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism</title><source>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</source><source>Springer Nature - SpringerLink Journals - Fully Open Access </source><creator>El-Morshedy, Reham M. ; El-kholy, Maha M. ; Hamad, Dina A. ; El-Sokkary, Rofaida R. ; Mohamed, Marwan N.</creator><creatorcontrib>El-Morshedy, Reham M. ; El-kholy, Maha M. ; Hamad, Dina A. ; El-Sokkary, Rofaida R. ; Mohamed, Marwan N.</creatorcontrib><description>Background
Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE).
Results
The studied cases were subdivided into two classes:
Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (
p
< 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (
p
< 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (
p
<0.001).
Conclusions
RVD/LVD ratio, TAPSE, TRPG/TAPSE ratio, and PA acceleration time are echocardiographic parameters that might be helpful for risk stratification of cases with moderate-risk pulmonary embolism. The addition of elevated levels of cardiac troponins to imaging and clinical findings can improve PE-related risk identification.
Trial registration
NCT04020250
. Registered on 16 July 2019.</description><identifier>ISSN: 2314-8551</identifier><identifier>ISSN: 1687-8426</identifier><identifier>EISSN: 2314-8551</identifier><identifier>DOI: 10.1186/s43168-023-00181-x</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anticoagulants ; Cardiac arrhythmia ; Chronic obstructive pulmonary disease ; Dyspnea ; Echocardiography ; Ejection fraction ; Medical imaging ; Medicine ; Medicine & Public Health ; Pulmonary arteries ; Pulmonary embolism ; Pulmonary embolisms ; Risk factors ; Risk stratifications</subject><ispartof>The Egyptian Journal of Bronchology, 2023-12, Vol.17 (1), p.6-7, Article 6</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-d04a6a1e0a329ab47d58f0d4909aac4d8e44b66d734879b18286b37b4755e67a3</citedby><cites>FETCH-LOGICAL-c457t-d04a6a1e0a329ab47d58f0d4909aac4d8e44b66d734879b18286b37b4755e67a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2766938524/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2766938524?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,25753,27924,27925,37012,44590,75126</link.rule.ids></links><search><creatorcontrib>El-Morshedy, Reham M.</creatorcontrib><creatorcontrib>El-kholy, Maha M.</creatorcontrib><creatorcontrib>Hamad, Dina A.</creatorcontrib><creatorcontrib>El-Sokkary, Rofaida R.</creatorcontrib><creatorcontrib>Mohamed, Marwan N.</creatorcontrib><title>Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism</title><title>The Egyptian Journal of Bronchology</title><addtitle>Egypt J Bronchol</addtitle><description>Background
Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE).
Results
The studied cases were subdivided into two classes:
Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (
p
< 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (
p
< 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (
p
<0.001).
Conclusions
RVD/LVD ratio, TAPSE, TRPG/TAPSE ratio, and PA acceleration time are echocardiographic parameters that might be helpful for risk stratification of cases with moderate-risk pulmonary embolism. The addition of elevated levels of cardiac troponins to imaging and clinical findings can improve PE-related risk identification.
Trial registration
NCT04020250
. Registered on 16 July 2019.</description><subject>Anticoagulants</subject><subject>Cardiac arrhythmia</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Dyspnea</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pulmonary arteries</subject><subject>Pulmonary embolism</subject><subject>Pulmonary embolisms</subject><subject>Risk factors</subject><subject>Risk stratifications</subject><issn>2314-8551</issn><issn>1687-8426</issn><issn>2314-8551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9kctOwzAQRSMEElXpD7CKxDpgx47tLFHFo1IlWMDamvjRuiRxsVNU_h63QcCKjcfynHs9o5tllxhdYyzYTaQEM1GgkhQIYYGL_Uk2KQmmhagqfPrnfp7NYtygRFUMCcwnWfsc_Kr3cXAq_4B2Z3Jvc6PWXkHQzq8CbNep5XrtlImp5sHFtzwOAQZnnUqn7w8a1w8mdEY7GExxZLa7tvM9hM_cdI1vXewusjMLbTSz7zrNXu_vXuaPxfLpYTG_XRaKVnwoNKLAABsEpKyhoVxXwiJNa1QDKKqFobRhTHNCBa8bLErBGsITWFWGcSDTbDH6ag8buQ2uS1NID04eH3xYSQhp49ZIYq1lnCCucEMR4JpwBdwyC4YwxVXyuhq9tsG_70wc5MbvQp_GlyVnrCaiKmmiypFSwccYjP35FSN5CEmOIckUkjyGJPdJREZRTHC_MuHX-h_VF-UJlwM</recordid><startdate>20231201</startdate><enddate>20231201</enddate><creator>El-Morshedy, Reham M.</creator><creator>El-kholy, Maha M.</creator><creator>Hamad, Dina A.</creator><creator>El-Sokkary, Rofaida R.</creator><creator>Mohamed, Marwan N.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>SpringerOpen</general><scope>C6C</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>DOA</scope></search><sort><creationdate>20231201</creationdate><title>Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism</title><author>El-Morshedy, Reham M. ; El-kholy, Maha M. ; Hamad, Dina A. ; El-Sokkary, Rofaida R. ; Mohamed, Marwan N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-d04a6a1e0a329ab47d58f0d4909aac4d8e44b66d734879b18286b37b4755e67a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anticoagulants</topic><topic>Cardiac arrhythmia</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Dyspnea</topic><topic>Echocardiography</topic><topic>Ejection fraction</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pulmonary arteries</topic><topic>Pulmonary embolism</topic><topic>Pulmonary embolisms</topic><topic>Risk factors</topic><topic>Risk stratifications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El-Morshedy, Reham M.</creatorcontrib><creatorcontrib>El-kholy, Maha M.</creatorcontrib><creatorcontrib>Hamad, Dina A.</creatorcontrib><creatorcontrib>El-Sokkary, Rofaida R.</creatorcontrib><creatorcontrib>Mohamed, Marwan N.</creatorcontrib><collection>SpringerOpen</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>The Egyptian Journal of Bronchology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El-Morshedy, Reham M.</au><au>El-kholy, Maha M.</au><au>Hamad, Dina A.</au><au>El-Sokkary, Rofaida R.</au><au>Mohamed, Marwan N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism</atitle><jtitle>The Egyptian Journal of Bronchology</jtitle><stitle>Egypt J Bronchol</stitle><date>2023-12-01</date><risdate>2023</risdate><volume>17</volume><issue>1</issue><spage>6</spage><epage>7</epage><pages>6-7</pages><artnum>6</artnum><issn>2314-8551</issn><issn>1687-8426</issn><eissn>2314-8551</eissn><abstract>Background
Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE).
Results
The studied cases were subdivided into two classes:
Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (
p
< 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (
p
< 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (
p
<0.001).
Conclusions
RVD/LVD ratio, TAPSE, TRPG/TAPSE ratio, and PA acceleration time are echocardiographic parameters that might be helpful for risk stratification of cases with moderate-risk pulmonary embolism. The addition of elevated levels of cardiac troponins to imaging and clinical findings can improve PE-related risk identification.
Trial registration
NCT04020250
. Registered on 16 July 2019.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1186/s43168-023-00181-x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Egyptian Journal of Bronchology, 2023-12, Vol.17 (1), p.6-7, Article 6 |
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| source | Publicly Available Content Database (Proquest) (PQ_SDU_P3); Springer Nature - SpringerLink Journals - Fully Open Access |
| subjects | Anticoagulants Cardiac arrhythmia Chronic obstructive pulmonary disease Dyspnea Echocardiography Ejection fraction Medical imaging Medicine Medicine & Public Health Pulmonary arteries Pulmonary embolism Pulmonary embolisms Risk factors Risk stratifications |
| title | Prognostic value of echocardiographic indices in risk stratification of intermediate-risk pulmonary embolism |
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