Right Ventricular Assessment by Tissue-Doppler Echocardiography in Acute Pulmonary Embolism

Rodrigues, Ana Clara Tude; Cordovil, Adriana; Monaco, Claudia; Guimarães, Laise; Cury, Alexandre Ferreira; Naccarato, Gustavo; Lira-Filho, Edgar; Fischer, Cláudio Henrique; Vieira, Marcelo Luiz Campos; Morhy, Samira Saady

doi:10.5935/abc.20130099

Cited by 11 publications

(17 citation statements)

References 21 publications

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“…In previous studies, increased BNP levels were demonstrated to be associated with adverse outcomes and RVD in patients with APE [26][27]. Ohigashi et al [26] investigated the role of BNP, D-dimer, troponin I, and C-reactive protein in predicting adverse outcomes and RVD in patients with APE and they demonstrated that only high plasma BNP level was found to be a predictor of RVD and short-and long-term prognosis of APE.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of serum copeptin levels in an acute pulmonary embolism

et al. 2016

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D-dimer (r = 0.315, p = 0.003) and troponin I (r = 0.300, p = 0.004) and inversely correlated with arterial oxygen saturations (r = -0.533, p < 0001). When the correlation of copeptin with right ventricular dysfunction parameters was investigated, it was significantly inversely correlated with the tricuspid annular plane systolic excursion (r = -0.521, p < 0.001) and positively cor related with right to left ventricle ratio (r = 0.329, p = 0.024). Copeptin (OR 1.836, p = 0.008) (Cardiol J 2016; 23, 1: 42-50)

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Section: Discussionmentioning

confidence: 99%

The diagnostic value of serum copeptin levels in an acute pulmonary embolism

et al. 2016

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“…Regarding tissue Doppler variables, both tissue Doppler s' velocities, an estimate of RV longitudinal function, and RV MPI, an index that incorporates systolic and diastolic function, correlated weakly to the severity of vascular obstruction. Despite the extensive data using tissue Doppler velocities for RV assessment [14,15], this analysis can be influenced by age, loading conditions and the presence of significant tricuspid regurgitation [16]. In a few patients with large PE and RV dysfunction (demonstrated both qualitatively and by FAC), RV myocardial s' velocities were not decreased if significant tricuspid regurgitation was present.…”

Section: Discussionmentioning

confidence: 98%

Relationship of clot burden and echocardiographic severity of right ventricular dysfunction after acute pulmonary embolism

Rodrigues

Guimarães

et al. 2014

Int J Cardiovasc Imaging

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The impact of pulmonary embolism on right ventricular (RV) performance can be evaluated by echocardiography, however, the relationship between pulmonary vascular involvement and RV burden is controversial. To assess the effect of clot burden on RV performance we studied 85 patients (aged 53 ± 17 years, 39 female) with confirmed PE by multislice computed tomography (CT) and echocardiography within 24 h of diagnosis. A CT score ranging from 1 to 20 points according to the pulmonary arteries involved was used. RV function was evaluated with fractional area change (FAC), with dysfunction present when FAC < 40%. Tissue Doppler RV systolic (s') velocities and myocardial performance index (MPI) were obtained, as well as pulmonary artery pressure (PAP). Mean CT score was 9.4 ± 6.7. Only 31 out of 85 patients (37%) presented with RV dysfunction, with FAC measuring 27.8 ± 7.2% in patients with dysfunction compared to 47.8 ± 4.4 for those with preserved RV function (p < 0.05). RV dysfunction was associated to older age, higher CT scores, increased pulmonary pressures and MPI and decreased s' (p < 0.001). An inverse correlation with CT clot burden was found for FAC (r = -0.57), whereas a direct correlation was seen for PAP (r = 0.51) and MPI (0.32). No correlation was observed for tissue Doppler velocities. In patients with acute PE, the effect of clot burden on RV performance is better expressed FAC than tissue Doppler indexes; the increase in pulmonary pressure is proportional to the magnitude of obstruction.

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“…We would like to thank Yalcinkaya et al 1 and coworkers for the worthy commentaries on our recent article 1 . Brain natriuretic peptide (BNP) is produced primarily in ventricular myocytes, and elevated levels are found mainly in patients with increased left ventricular and pulmonary artery pressure.…”

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confidence: 91%

“…We read with great interest the article by Rodrigues et al 1 entitled "Right Ventricular Assessment by Tissue-Doppler Echocardiography in Acute Pulmonary Embolism", which was published of the Arquivos Brasileiros de Cardiologia. The authors 1 aimed to evaluate the right ventricular (RV) systolic function using two-dimensional tissue Doppler echocardiography in patients with acute pulmonary embolism (PE) and to analyze its correlation with atrial natriuretic peptide (BNP) levels.…”

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confidence: 99%

“…The authors 1 aimed to evaluate the right ventricular (RV) systolic function using two-dimensional tissue Doppler echocardiography in patients with acute pulmonary embolism (PE) and to analyze its correlation with atrial natriuretic peptide (BNP) levels. The authors concluded that increased BNP levels (≥ 50 pg/mL) were associated with a higher prevalence of RV systolic dysfunction in patients with PE.…”

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confidence: 99%

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