Echocardiographic Pattern of Acute Pulmonary Embolism: Analysis of 511 Consecutive Patients
Echocardiographic Pattern of Acute Pulmonary Embolism: Analysis of 511 Consecutive Patients
复制标题
DOI：
10.1016/j.echo.2016.05.016
复制
发表时间：
2016-09-01
影响因子：
6.5
通讯作者：
Pruszczyk, Piotr
中科院分区：
文献类型：
--
作者：
Kurnicka, Katarzyna;Lichodziejewska, Barbara;Pruszczyk, Piotr
背景：目前尚未对经胸超声心动图显示的肺栓塞（PE）进行全面分析。本研究的目的是评估右心室（RV）功能障碍（RVD）的频率，急性PE （TES）的典型超声心动图征象，以及偶然的异常。方法：对511例连续患者（281名女性，平均年龄64.0 +/- 18.6岁）进行单中心回顾性分析，经对比增强多探测器计算机断层扫描证实PE，并行经胸超声心动图评估左室和右室改变。视麦康奈尔征、“60/60”征、右心血栓为TES。RVD包括左室游离壁萎缩和左室/左室舒张末期比值>.9。偶然的超声心动图改变也有报道。结果：左室增大、左室游离壁收缩、室间隔扁平分别占27.4%、26.6%和18.4%。三尖瓣反流峰值收缩期梯度> ~ 30mmhg、肺射血加速时间< 80msec分别占46.6%和37.2%。20.0%的患者存在RVD，而33.4%的患者存在正常的RVD功能。麦康奈尔征、60/60征、右心血栓分别占19.8%、12.9%、1.8%。所有16例血流动力学不稳定的PE患者均表现为右心室缩小和至少一例TES。但其中3例左室/左室舒张末期比值为
Background: There is no comprehensive analysis of transthoracic echocardiographic findings of pulmonary embolism (PE). The aim of this study was to assess the frequency of right ventricular (RV) dysfunction (RVD), typical echocardiographic signs of acute PE (TES), and incidental abnormalities.Methods: A single-center, retrospective analysis was conducted of 511 consecutive patients (281 women; mean age, 64.0 +/- 18.6 years) with PE confirmed by contrast-enhanced multidetector computed tomography who underwent transthoracic echocardiography for the assessment of left ventricular and RV alterations. The McConnell sign, the "60/60'' sign, and right heart thrombus were regarded as TES. RVD included RV free wall hypokinesis and RV to LV end-diastolic ratio >0.9. Incidental echocardiographic alterations were also reported.Results: RV enlargement, RV free wall hypokinesis, and interventricular septal flattening were found in 27.4%, 26.6%, and 18.4% of patients, respectively. Tricuspid regurgitation peak systolic gradient > 30 mmHg and pulmonary ejection acceleration time < 80 msec were measured in 46.6% and 37.2% of patients, respectively. RVD was found in 20.0% of patients, while normal RV function was present in 33.4% of patients. The McConnell sign, 60/60 sign, and right heart thrombus were found in 19.8%, 12.9%, 1.8% of subjects, respectively. All 16 hemodynamically unstable patients with PE presented enlarged hypokinetic right ventricle and at least one TES. However, in three of them, RV to LV end-diastolic ratio was