0
Original Research: PULMONARY EMBOLISM |

Prognostic Value of Echocardiographic Right/Left Ventricular End-Diastolic Diameter Ratio in Patients With Acute Pulmonary Embolism*: Results From a Monocenter Registry of 1,416 Patients

Benoît Frémont, MD; Gérard Pacouret, MD; David Jacobi, MD; Raphaël Puglisi, MD; Bernard Charbonnier, MD; Axel de Labriolle, MD
Author and Funding Information

*From the Intensive Care Unit and Cardiology A Department (Drs. Frémont, Pacouret, Puglisi, Charbonnier, and de Labriolle), Trousseau Hospital; and INSERM Unit 202 (Dr. Jacobi), Clinical Investigation Center, Bretonneau Hospital and François Rabelais University, Tours, France.

Correspondence to: Gérard Pacouret, MD, Intensive Care Unit and Cardiology A Department, Trousseau Hospital, 37044 Tours Cedex, France; e-mail: g.pacouret@chu-tours.fr



Chest. 2008;133(2):358-362. doi:10.1378/chest.07-1231
Text Size: A A A
Published online

Background: In the literature, echocardiographic assessment of the prognosis of acute pulmonary embolism is based on analysis of right ventricle free-wall motion or on a composite index combining right ventricular dilatation, paradoxical septal wall motion, and pulmonary hypertension. The aim of this study was to determine the prognostic value of a single quantitative echocardiographic criterion, the right/left ventricular end-diastolic diameter (RV/LV) ratio.

Methods: Registry data on 1,416 consecutive patients hospitalized for acute pulmonary embolism were used to study retrospectively a population of 950 patients who underwent echocardiographic assessment on hospital admission and for whom the RV/LV ratio was available.

Results: The hospital mortality rate for the series was 3.3%. Sensitivity and specificity of RV/LV ratio ≥ 0.9 for predicting hospital mortality were 72% and 58%, respectively. Multivariate analysis showed the independent predictive factors for hospital mortality to be the following: systolic BP < 90 mm Hg (odds ratio [OR], 10.73; p < 0.0001), history of left heart failure (OR, 8.99; p < 0.0001), and RV/LV ratio ≥ 0.9 (OR, 2.66; p = 0.01).

Conclusions: In our retrospective series, an echocardiographic RV/LV ratio ≥ 0.9 was shown to be an independent predictive factor for hospital mortality. This criterion may be of value in selecting cases of submassive pulmonary embolism with a poor prognosis that are liable to benefit from thrombolytic treatment.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
Guidelines
Venous thromboembolism diagnosis and treatment.
Institute for Clinical Systems Improvement | 6/26/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543