Prognostic echocardiographic parameters in hospitalized patients with pulmonary embolism

Abstract

Pulmonary embolism (PE) is considered one of the most common cardiovascular diseases with considerable mortality. Echocardiography remains an important investigation in the evaluation of these patients, with some echocardiographic parameters playing an incremental role in prognostic evaluation.Objectives: To determine the spectrum of echocardiographic changes in patients hospitalized with pulmonary embolism at the Institute of Cardiology of the Republic of Moldova and to highlight parameters with significant prognostic value in relation to risk scores for mortality stratification in PE. Materials and methods: We prospectively enrolled 168 patients admitted to the Institute of Cardiology. All patients were evaluated by transthoracic echocardiography. Results: Parameters most associated with in-hospital mortality at 30 days were: right atrial area (RA) >18cm2 (p=0.007), tricuspid valve regurgitation (TR) grade (p=0.002), tissue systolic velocity of the anterior wall of the right ventricle (RV) (p=0.03), inferior vena cava diameter (p=0.04), RV/LV ratio >1.0 (p=0.04), and TAPSE/PSAP index <0.4 (p<0.008). Conclusions: Echocardiographic parameters such as tricuspid valve regurgitation grade, RA area, tissue systolic velocity of the anterior RV wall, TAPSE/PSAP index, and interventricular ratio have additive value in evaluating prognosis in patients with PE.