Table 2.
Prognostic value of echocardiographic parameters in acute pulmonary embolism
| Parameter | Study design | Outcomes | OR or HR (95% CI) | Main findings |
|---|---|---|---|---|
| RV dysfunction | Meta-analysis [68] (n = 1,249) | All-cause mortality | 2.4 (1.3–4.3) | The presence of echocardiographic RV dysfunction is associated with short-term mortality in PE patients without hemodynamic compromise. |
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| TAPSE | Prospective cohort [27] (n = 782) | All-cause mortality PE-related mortality |
2.3 (1.2–4.7) 4.4 (1.3–15.3) |
TAPSE ≤ 16 mm was a significant predictor of all-cause mortality and PE-related mortality in normotensive patients. |
| Prospective cohort [45] (n = 411) | PE-related mortality rescue thrombolysis | 27.9 (6.2–124.6) | TAPSE ≤ 15 mm was independent predictor of increased risk of 30-day PE-related mortality or rescue thrombolysis. | |
| Prospective cohort [69] (n = 76) | PE-related mortality | 26.2 (3.2–214.1) | TAPSE ≤ 15 mm was a significant predictor of PE-related mortality. The TAPSE is preferable to echo and MDCT RV to LV ratio for risk stratification in initially normotensive patients. | |
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| Right heart thrombi | Meta-analysis [73] (n = 15,220) | All-cause mortality PE-related mortality | 3.0 (2.2–4.1) 4.8 (2.0–11.3) |
In acute PE patients, concomitant right heart thrombi had a significant association with short-term all-cause mortality and PE-related mortality. |
| Prospective cohort [71] (n = 138) | PE-related mortality All-cause mortality |
2.7 (1.7–5.6) | In patients with concomitant right heart thrombi, 30-day all-cause mortality was greater than propensity score-matched controls. | |
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| RV strain (STE) | Prospective cohort [75] (n = 66) | PE-related adverse outcomes | 2.3 (1.5–3.9) | RV mid free wall longitudinal strain and 3-dimentional RV EF were independently associated with 6-month adverse outcomes. |
| Prospective cohort [76] (n = 144) | In-hospital events (PE-related death, need to inotropics, thrombolysis) | 1.1 (1.0–1.2) | RV free wall and global wall strain is an independent prognostic marker for in-hospital events in patients with acute non-massive PE. | |
OR, odds ratio; HR, hazard ratio; CI, confidential interval; RV, right ventricle; PE, pulmonary embolism; TAPSE, tricuspid annulus plane systolic excursion; MDCT, multidetector computed tomographic; LV, left ventricle; EF, ejection fraction; STE, speckle-tracking echocardiography.