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...

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Autores principales:	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
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	pulmonary artery pressure pulmonary embolism right ventricle stroke volume Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/39d91feab448426c88d1192df3ed9a41
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spelling	oai:doaj.org-article:39d91feab448426c88d1192df3ed9a412021-11-23T11:36:35ZSimultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism10.1161/JAHA.120.0198492047-9980https://doaj.org/article/39d91feab448426c88d1192df3ed9a412021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.019849https://doaj.org/toc/2047-9980Background 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.Hayaan KamranEssa H. HaririJean‐Pierre IskandarAditya SahaiIhab HaddadinSerge C. HarbJoseph CampbellLeben TeferaJoseph M. DelehantyGustavo A. HeresiJohn R. BartholomewScott J. CameronWileyarticlepulmonary artery pressurepulmonary embolismright ventriclestroke volumeDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pulmonary artery pressure pulmonary embolism right ventricle stroke volume Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	pulmonary artery pressure pulmonary embolism right ventricle stroke volume Diseases of the circulatory (Cardiovascular) system RC666-701 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
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.
format	article
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
title	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_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_sort	simultaneous pulmonary artery pressure and left ventricle stroke volume assessment predicts adverse events in patients with pulmonary embolism
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/39d91feab448426c88d1192df3ed9a41
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Simultaneous Pulmonary Artery Pressure and Left Ventricle Stroke Volume Assessment Predicts Adverse Events in Patients With Pulmonary Embolism

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