Normotensive acute PE patients with RVD and normal troponin levels have significantly higher prevalence of chronic cardiovascular diseases (77.4% vs 47.6%, p<0.001).
What is the role of pre-existing cardiovascular diseases in normotensive acute pulmonary embolism patients with right ventricle dysfunction and normal cardiac troponin levels?
The majority of normotensive acute PE patients with right ventricle dysfunction and normal cardiac troponin have pre-existing chronic cardiovascular conditions, suggesting RVD in this cohort may often reflect baseline disease rather than acute PE severity.
Absolute Event Rate: 0% vs 0%
Background. Current guidelines for acute pulmonary embolism (PE) management classify patients with heart right ventricle dysfunction (RVD) who do not have elevated cardiac troponin (cTn) blood levels as intermediate low risk patients. The aim of this investigation is to study the characteristics of these patients and the role of pre-existing cardiovascular diseases for the RVD. Methodology. Out of 1675 patients with acute PE from the regional PE registry, we included 353 normotensive patients who had echocardiography imaging at presentation to hospital and normal blood levels of cTn. Patients were divided into low risk PE if they hadn't RVD and intermediate-low risk if they had RVD and their characteristics were compared. Results. A 216 patients with low risk PE were significantly younger than 137 patients with intermediate-low risk. Arterial hypertension, chronic heart failure with reduced ejection fraction, coronary disease and diabetes mellitus type 2 were all significantly more prevalent in patients with intermediate-low risk (p0.001 for all comparisons) compare to low risk patients (77.4% vs 47.6%, p0.001 for the presence of at least one of the four mentioned cardiovascular diseases). The age and sex adjusted odds ratio to have at least one of the mentioned cardiovascular diseases and intermediatelow PE was 2.954 (95%CI 1.658-5.266). Conclusions. The majority of normotensive acute PE patients with RVD and normal cTn are actually chronic cardiovascular patients.
Obradović et al. (Mon,) reported a other. Normotensive acute PE patients with RVD and normal troponin levels have significantly higher prevalence of chronic cardiovascular diseases (77.4% vs 47.6%, p<0.001).