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Right Ventricular Early Inflow‐Outflow Index—A new method for echocardiographic evaluation of right ventricle dysfunction in acute pulmonary embolism
Author(s) -
Acar Emrah,
İzci Servet,
Inanir Mehmet,
Yılmaz Mehmet Fatih,
Izgi Ibrahim Akin,
Kirma Cevat
Publication year - 2020
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14591
Subject(s) - medicine , cardiology , pulmonary embolism , receiver operating characteristic , ventricle , area under the curve
Acute pulmonary embolism (APE) is a cardiothoracic thromboembolic emergency at risk of life‐threatening. Several risk graduation algorithms may be applied to delineate short‐term mortality in patients with APE. In this study, we aim to depict the relationship between the right ventricular early inflow‐outflow (RVEIO) index, which is a Doppler‐based parameter, and the pulmonary embolism severity index(PESI) in acute pulmonary embolism. Methods In the presented study, a total of 160 patients who were diagnosed with APE using pulmonary computed tomography angiography or ventilation/perfusion scintigraphy were comprised. Patients were separated to 2 groups based on the simplified PESI (sPESI): sPESI < 1 (n = 88) and sPESI ≥ 1 (n = 72). Echocardiographic parameters, including the RVEIO index, were measured. Results There were no significant differences between the groups in age and gender distribution, or the presence of diabetes mellitus, hypertension, smoking, and history of coronary artery disease. There was a positive correlation with the mortality rate and RVEIO index; the mortality was higher in patients with a higher RVEIO index(<0.001). In receiver operating characteristic (ROC) curve analysis using a cutoff level of 14.39, RVEIO index predicted mortality with a sensitivity of 80.4% and specificity of 57.6%(ROC area under curve:0.694; 95%CI, 0.581‐0.814; P < .001). RVEIO index was higher in the sPESI ≥ 1(n:72) than in the patients with sPESI < 1(14.27 ± 2.13 vs 10.63 ± 2.09; P < .001). There was a positive correlation between RVEIO index and sPESI score(+0.428; P < .001). Conclusion As well as predicting the degree of tricuspid regurgitation (TR), the RVEIO index is well‐correlated with sPESI score and is associated with mortality in patients with APE. This easily measurable parameter may be used to predict short‐term mortality in APE patients.