Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism.
Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism.
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DOI：
10.1161/jaha.120.019849
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发表时间：
2021-09-21
影响因子：
5.4
通讯作者：
Cameron SJ
中科院分区：
文献类型：
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作者：
Kamran H;Hariri EH;Iskandar JP;Sahai A;Haddadin I;Harb SC;Campbell J;Tefera L;Delehanty JM;Heresi GA;Bartholomew JR;Cameron SJ
某些超声心动图参数可作为血流动力学受损肺栓塞（PE）患者不良事件的早期预测因子。对2014年至2020年间由肺栓塞反应小组（PERT）评估的急性肺栓塞患者进行了观察性分析。通过将肺动脉收缩压除以左心室每搏输出量，使用右心室和左心室血流动力学的比值比较临床预测算法（包括肺栓塞严重程度指数和Carl Bova评分）的性能。通过单变量和多变量分析评价了住院死亡率、心脏骤停和高级治疗需求的主要结局。在符合入选标准的343例患者中，215例有完整的数据。肺动脉收缩压/左心室每搏输出量是主要终点的明确预测因子（比值比[OR]，2.31; P=0.005），其表现与肺栓塞严重程度指数（OR，1.43; P=0.06）或Bova评分（OR，1.28; P=0.01）相同或更好。本研究是第一项证明早期肺动脉收缩压/左心室每搏输出量在预测急性肺栓塞患者不良临床事件中的实用性的研究。肺动脉收缩压/左心室每搏输出量可能是高风险肺栓塞中心室颤动的替代标志物，应进行影像学评价。
Certain echocardiographic parameters may serve as early predictors of adverse events in patients with hemodynamically compromising pulmonary embolism (PE). An observational analysis was conducted for patients with acute pulmonary embolism evaluated by a Pulmonary Embolism Response Team (PERT) between 2014 and 2020. The performance of clinical prediction algorithms including the Pulmonary Embolism Severity Index and Carl Bova score were compared using a ratio of right ventricle and left ventricle hemodynamics by dividing the pulmonary artery systolic pressure by the left ventricle stroke volume. The primary outcome of in‐hospital mortality, cardiac arrest, and the need for advanced therapies was evaluated by univariate and multivariable analyses. Of the 343 patients meeting the inclusion criteria, 215 had complete data. Pulmonary artery systolic pressure/left ventricle stroke volume was a clear predictor of the primary end point (odds ratio [OR], 2.31; P=0.005), performing as well or better than the Pulmonary Embolism Severity Index (OR, 1.43; P=0.06) or the Bova score (OR, 1.28; P=0.01). This study is the first study to demonstrate the utility of early pulmonary artery systolic pressure/left ventricle stroke volume in predicting adverse clinical events in patients with acute pulmonary embolism. Pulmonary artery systolic pressure/left ventricle stroke volume may be a surrogate marker of ventricular asynchrony in high‐risk pulmonary embolism and should be prognostically evaluated.