Pulmonary Embolism and Right Heart Thrombi: A Single-Center Experience

Jenab, Yaser; Ariannejad, Hamid; Rabbani, Zahra; Soveyzi, Faezeh; Hosseinsabet, Ali; Shirani, Shapour

doi:10.18502/jthc.v16i1.6597

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…The risk factors for RHT also varied in different studies. Previous studies reported that RHT‐APE patients had lower SBP, 4 , 6 higher APE risk stratification, 6 higher proportion of RV hypokinesis, 4 , 5 , 6 , 14 and higher BNP levels, 6 which were in consistence with our study. Besides, the present study also reported that RHT patients had younger age, 6 higher proportion of male gender, 15 and higher levels of creatinine, 6 which were also in line with others' studies.…”

Section: Discussionsupporting

confidence: 92%

Right heart thrombus in acute pulmonary embolism: A single center experience in China

Li,

Liu,

Chen

et al. 2023

Pulm. circ.

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Right heart thrombus (RHT) is a rare but life‐threatening condition in acute pulmonary embolism (APE) without clear management guidelines. This study aimed to address the clinical characteristics and outcomes of RHT‐APE in Chinese patients. In this study, 17 RHT‐APE and 329 non‐RHT‐APE patients, who were diagnosed between September 2015 and August 2019, were retrospectively recruited with the median follow‐up was 360 days. The overall prevalence of RHT was 4.91% in APE. Its prevalence increased along the increase of APE risk stratifications. Comparisons showed that with higher proportion of male gender and younger age, RHT‐APE patients also had worse hemodynamic instability and heart function, and higher risk stratification levels than non‐RHT‐APE patients. After adjusting by age and gender, multivariate logistic regression analysis found high/intermediate‐high risk stratification, decreased right ventricular (RV) motion, NT‐proBNP >600 pg/mL, and RV dysfunction were risk factors for RHT. Kaplan−Meier analysis showed non‐RHT had better prognosis than RHT patients (30‐day survival: log‐rank: p < 0.001; 90‐day survival: log‐rank: p = 0.002). The multivariate logistic regression analysis showed RHT was an independent risk factor for 30‐day mortality in APE. The subgroup analysis showed RHT would result in worse outcomes in patients who already had higher APE early mortality risk. RHT would increase the risk of 30‐ and 90‐day mortality in APE. More attention should be paid to young male APE patients with decreased RV motion, NT‐proBNP >600 pg/mL, RV dysfunction, or high level of risk stratification, to exclude the coexistence of RHT.

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Section: Discussionsupporting

confidence: 92%

Right heart thrombus in acute pulmonary embolism: A single center experience in China

Li,

Liu,

Chen

et al. 2023

Pulm. circ.

View full text Add to dashboard Cite

show abstract

“…In the same manner, the loss of the corresponding right ventricle contribution to the preloading of the left ventricle in AF can aggravate hemodynamic disturbances in patients with PE [24,25]. In particular, in patients with permanent AF, the thrombotic embolus may originate from the right atrium [26,27]. AF promotes a pro-thrombotic state by inducing the production of platelets and coagulation cascades, which can lead to thrombosis and eventual PE.…”

Section: Discussionmentioning

confidence: 99%

New-Onset Paroxysmal Atrial Fibrillation in the Setting of Acute Pulmonary Embolism Is Associated with All-Cause Hospital Mortality in Women but Not in Men

et al. 2023

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Background: Patients with acute pulmonary embolism (PE) may have various types of atrial fibrillation (AF). The role of AF in hemodynamic states and outcomes may differ between men and women. Methods: In total, 1600 patients (743 males and 857 females) with acute PE were enrolled in this study. The severity of PE was assessed using the European Society of Cardiology (ESC) mortality risk model. Patients were allocated into three groups according to their electrocardiography recordings taken during hospitalization: sinus rhythm, new-onset paroxysmal AF, and persistent/permanent AF. The association between the types of AF and all-cause hospital mortality was tested using regression models and net reclassification index (NRI) and integrated discrimination index (IDI) statistics with respect to sex. Results: There were no differences between the frequencies of the types of AF between men and women: 8.1% vs. 9.1% and 7.5% vs. 7.5% (p = 0.766) for paroxysmal and persistent/permanent AF, respectively. We found that the rates of paroxysmal AF significantly increased across the mortality risk strata in both sexes. Among the types of AF, the presence of paroxysmal AF had a predictive value for all-cause hospital mortality independent of mortality risk and age in women only (adjusted HR, 2.072; 95% CI, 1.274–3.371; p = 0.003). Adding paroxysmal AF to the ESC risk model did not improve the reclassification of patient risk for the prediction of all-cause mortality, but instead enhanced the discriminative power of the existing model in women only (NRI, not significant; IDI, 0.022 (95% CI, 0.004–0.063); p = 0.013). Conclusion: The occurrence of paroxysmal AF in female patients with acute PE has predictive value for all-cause hospital mortality independent of age and mortality risk.

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Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report

Feng¹,

Wang²,

Li³

et al. 2023

J Biomed Res

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Pulmonary Embolism and Right Heart Thrombi: A Single-Center Experience

Cited by 3 publications

References 9 publications

Right heart thrombus in acute pulmonary embolism: A single center experience in China

Right heart thrombus in acute pulmonary embolism: A single center experience in China

New-Onset Paroxysmal Atrial Fibrillation in the Setting of Acute Pulmonary Embolism Is Associated with All-Cause Hospital Mortality in Women but Not in Men

Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: A case report

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