Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism
Background Certain echocardiographic parameters may serve as early predictors of adverse events in patients with hemodynamically compromising pulmonary embolism (PE). Methods and Results An observational analysis was conducted for patients with acute pulmonary embolism evaluated by a Pulmonary Embol...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.019849 |
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| author | Hayaan Kamran Essa H. Hariri Jean‐Pierre Iskandar Aditya Sahai Ihab Haddadin Serge C. Harb Joseph Campbell Leben Tefera Joseph M. Delehanty Gustavo A. Heresi John R. Bartholomew Scott J. Cameron |
| author_facet | Hayaan Kamran Essa H. Hariri Jean‐Pierre Iskandar Aditya Sahai Ihab Haddadin Serge C. Harb Joseph Campbell Leben Tefera Joseph M. Delehanty Gustavo A. Heresi John R. Bartholomew Scott J. Cameron |
| author_sort | Hayaan Kamran |
| collection | DOAJ |
| description | Background Certain echocardiographic parameters may serve as early predictors of adverse events in patients with hemodynamically compromising pulmonary embolism (PE). Methods and Results 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). Conclusions 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. |
| first_indexed | 2024-04-09T15:39:36Z |
| format | Article |
| id | doaj.art-39d91feab448426c88d1192df3ed9a41 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T15:39:36Z |
| publishDate | 2021-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-39d91feab448426c88d1192df3ed9a412023-04-27T11:12:16ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-09-01101810.1161/JAHA.120.019849Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary EmbolismHayaan Kamran0Essa H. Hariri1Jean‐Pierre Iskandar2Aditya Sahai3Ihab Haddadin4Serge C. Harb5Joseph Campbell6Leben Tefera7Joseph M. Delehanty8Gustavo A. Heresi9John R. Bartholomew10Scott J. Cameron11Department of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDepartment of Medicine Cleveland Clinic Foundation Cleveland OHDepartment of Medicine Cleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDepartment of Radiology Cleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDivision of Cardiology Department of Medicine University of Rochester Medical Center Rochester NYDepartment of Pulmonary and Critical Care Medicine Respiratory InstituteCleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHDepartment of Cardiovascular Medicine Heart Vascular and Thoracic InstituteCleveland Clinic Foundation Cleveland OHBackground Certain echocardiographic parameters may serve as early predictors of adverse events in patients with hemodynamically compromising pulmonary embolism (PE). Methods and Results 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). Conclusions 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.https://www.ahajournals.org/doi/10.1161/JAHA.120.019849pulmonary artery pressurepulmonary embolismright ventriclestroke volume |
| spellingShingle | Hayaan Kamran Essa H. Hariri Jean‐Pierre Iskandar Aditya Sahai Ihab Haddadin Serge C. Harb Joseph Campbell Leben Tefera Joseph M. Delehanty Gustavo A. Heresi John R. Bartholomew Scott J. Cameron Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease pulmonary artery pressure pulmonary embolism right ventricle stroke volume |
| title | Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism |
| title_full | Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism |
| title_fullStr | Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism |
| title_full_unstemmed | Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism |
| title_short | Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism |
| title_sort | simultaneous pulmonary artery pressure and left ventricle stroke volume assessment predicts adverse events in patients with pulmonary embolism |
| topic | pulmonary artery pressure pulmonary embolism right ventricle stroke volume |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.019849 |
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