Echocardiography Helps Predict Pulmonary Embolism Outcomes

A new study suggests that transthoracic echocardiography (TTE) can help clinicians calculate short-term mortality outcomes for patients with acute pulmonary embolism (PE).

For the study, researchers at New York-Presbyterian Hospital/Columbia University Medical Center (NYP; New York, NY, USA), University Hospital Lausanne (CHUV; Switzerland), and other institutions extracted data for the years 2001-2017 from Registro Informatizado Enfermedad TromboEmbolica (RIETE), a 179 collaborating centers registry of consecutive patients with acute PE in the Americas, Asia, and Europe. An analysis was then conducted in order to determine contemporary utilization of early TTE and explore the association between TTE findings and PE‐related mortality.

The results revealed that among 35,935 enrollees with acute PE, 42.8% underwent early TTE, with an evident increase in early TTE utilization rate over time. Younger age, female sex, history of coronary disease, heart failure (HD), atrial fibrillation (AF), tachycardia, and hypotension were the main predictors of early TTE. In multivariable analyses, right atrial enlargement, right ventricular hypokinesis, and right heart thrombi were associated with increased odds for PE‐related mortality. The study was published on August 26, 2018, in the Journal of the American Heart Association.

“Acute pulmonary embolism is a serious thromboembolic condition accounting for thousands of hospitalizations and associated with high short-term mortality rates. Some studies suggest that TTE could help in the early risk stratification of patients with acute PE,” concluded lead author Behnood Bikdeli, MD, of NYP, and colleagues. “Early TTE was performed in over one-third of patients, and the proportion increased over time. History of prior cardiovascular disease and clinical markers of PE severity were among the main predictors of early TTE.”

TTE is the most common type of echocardiogram, involving an ultrasonic transducer placed non-invasively on the chest or abdomen to assess the overall health of the heart, including evaluation of all four chambers, the condition of the heart valves, the endocardium, and the aorta. It can be used to detect a heart attack, enlargement or hypertrophy of the heart, infiltrations, cardiac tumors and a variety of other findings. The images are displayed on-screen for real-time viewing, and then recorded.

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New York-Presbyterian Hospital
University Hospital Lausanne