Regression of right ventricular hypokinesis after thrombolysis in acute pulmonary embolism

Metz, Damien; Nazeyrollas, Pierre; Maillier, B; Jennesseaux, C; Tassan, S; Maes, D; Elaerts, J

doi:10.1016/s0002-9149(96)00177-4

Cited by 12 publications

(2 citation statements)

References 14 publications

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“…In addition, follow-up CT scans were obtained late after the initiation of reperfusion therapy, and recovery from RV enlargement likely had occurred prior to the time of follow-up CT. From prior echocardiographic studies, we have learned that right ventricular dysfunction may normalize within a few days after thrombolysis. [9][10][11] Less is known about the dynamic response of the right ventricle following surgical embolectomy. In our study, recovery from right ventricular enlargement on chest CT was similar in thrombolysis and surgical embolectomy patients.…”

Section: Discussionmentioning

confidence: 99%

Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism

et al. 2005

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Right ventricular (RV) enlargement, assessed by two-dimensional reconstructed 4-chamber views on contrast-enhanced multirow detector computed tomography (MDCT), is emerging as an important marker for predicting adverse clinical events in patients with acute pulmonary embolism (PE). It is unclear whether dynamic changes occur on chest computed tomography (CT) in response to thrombolysis or embolectomy to treat acute PE. We retrospectively investigated 23 consecutive patients who met the criteria of (1) a positive MDCT PE protocol; (2) RV dysfunction on echocardiography; (3) reperfusion therapy by systemic thrombolysis (n = 17) or surgical embolectomy (n = 6); and (4) follow-up MDCT study after completion of therapy. Two blinded observers reconstructed 4-chamber views on a Leonardo™ (Siemens, Munich, Germany) workstation using multiplanar reformats of axial CT data and then measured right and left ventricular dimensions (RVD, LVD). RV enlargement was defined as RVD/LVD ≥ 0.9. Mean age was 52 years, and there were 10 (43%) women. The median time to MDCT follow-up was 21 (range 2-231) days. Seventeen (74%) patients had their chest MDCT follow-up within 30 days. All 23 patients had RV enlargement (mean RVD/LVD 1.28, range 0.94 to 1.74) prior to initiation of reperfusion therapy. Although right ventricular enlargement was found in 43% of patients at follow-up, the mean RVD/LVD decreased from 1.28 ± 0.21 cm to 0.94 ± 0.16 cm (p = 0.001). The mean change in RVD/LVD was 0.31 ± 0.42 in thrombolysis patients and 0.42 ± 0.09 in embolectomy patients (p = 0.33). Reconstructed 4-chamber views on chest CT provide noninvasive imaging of right ventricular enlargement and permit dynamic assessment of the right ventricular response to thrombolysis and embolectomy in patients with acute PE.

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Section: Discussionmentioning

confidence: 99%

Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism

et al. 2005

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“…He also found decreased severity or resolution of tricuspid regurgitation and PAH, and improvement or resolution of RV hypokinesis and septal flattening. In another prospective trial [25] of 14 normotensive patients with RVD, significant decreases in RVED area, RV/LV, tricuspid regurgitant flow, and PAH were noted one hour after APE thrombolysis.…”

Section: Rvd On Tte In Apementioning

confidence: 95%

Value of transthoracic echocardiography in therapy regimens evaluation in pulmonary embolism

Zhu

Wang

Yang

et al. 2007

J Thromb Thrombolysis

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TTE documented the identical effect of thrombolytic regimen of urokinase 12 h, urokinase 2 h, rtPA 50 mg and rtPA 100 mg in major APE which suggest rtPA 100 mg can supersede rtPA 50 mg in these patients. Heparin produced the similar results compared with nadroparin in minor APE. TTE can monitor the effect DC3 NAK of thrombolysis early and identify the patients with persistent pulmonary hypertension which possibly develop chronic thromboembolic pulmonary hypertension. Therefore, it can facilitate the management of APE.

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Association of Persistent Right Ventricular Dysfunction at Hospital Discharge After Acute Pulmonary Embolism With Recurrent Thromboembolic Events

Grifoni

Vanni²,

Magazzini³

et al. 2006

Arch Intern Med

111

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Regression of right ventricular hypokinesis after thrombolysis in acute pulmonary embolism

Cited by 12 publications

References 14 publications

Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism

Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism

Value of transthoracic echocardiography in therapy regimens evaluation in pulmonary embolism

Association of Persistent Right Ventricular Dysfunction at Hospital Discharge After Acute Pulmonary Embolism With Recurrent Thromboembolic Events

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