Prognostic Value of Right Ventricular Dysfunction Markers for Serious Adverse Events in Acute Normotensive Pulmonary Embolism

摘要: Abstract Background Right ventricular dysfunction (RVD) in pulmonary embolism (PE) has been associated with increased morbidity. Tools for RVD identification are not well defined. The prognostic value of markers to predict serious adverse events (SAE) during hospitalization is unclear. Objective Prospectively compare the incidence SAE normotensive emergency department patients PE based upon by goal-directed echocardiography (GDE), cardiac biomarkers, and right-to-left ventricle ratio computed tomography (CT). Simplified Pulmonary Embolism Severity Index (sPESI) was calculated. Deaths readmissions within 30 days were recorded. Methods Consecutive underwent GDE focused on (RV enlargement, hypokinesis, or septal bowing), serum troponin, brain natriuretic peptide (BNP), evaluation CT ratio. In-hospital complications Results We enrolled 123 (median age 59 years, 49% female). Twenty-six (26%) had one more SAE. detected 26% GDE, 39% 38% CT. included death, six respiratory interventions, dysrhythmias, three major bleeding episodes, 21 hypotension episodes. Forty-one percent positive SAE, compared 18% negative GDE. Odds ratios CT, BNP, sPESI 3.2 (95% confidence interval [CI] 1.2–8.5), 2.0 CI 0.8–5.1), 3.3 1.3–8.6), 4.2 1.4–13.5), 2.9 1.1–8.3), respectively. Five non-PE-related deaths 30 days. Conclusion days significant our cohort. Those an risk nonmortality