Severe right heart dysfunction on echocardiogram was associated with higher rates of pulmonary embolism intervention compared to normal parameters, except for tricuspid regurgitation peak velocity.
Observational (n=40)
No
Does echocardiographic severity of right heart dysfunction correlate with the rate of pulmonary embolism intervention in patients with PE?
Severe right heart dysfunction on echocardiogram, specifically assessed by RVSP, TAPSE, and S', is associated with higher rates of intervention in patients with pulmonary embolism.
Abstract Rationale Pulmonary embolism (PE) remains a leading cause of morbidity and mortality. Therefore, rapid diagnosis and subsequent intervention are essential. The European Society of Cardiology (ESC) recommends the use of echocardiogram to diagnose high-risk PE. Recently, new guidelines by the American Society of Echocardiography (ASE) grade right heart dysfunction severity based on commonly reported parameters. We aimed to assess the relationship between right heart dysfunction severity on echocardiogram and rate of pulmonary embolism intervention. Methods A retrospective observational study was performed with 40 patients diagnosed with PE between 11/2020 and 5/2022 at Temple University Hospital who underwent inpatient transthoracic echocardiogram prior to any intervention. Echocardiogram data was collected to assess right ventricular dysfunction and severity including right ventricular systolic pressure (RVSP), tricuspid annular plane systolic excursion (TAPSE), tricuspid regurgitation peak velocity (TRV), and lateral tricuspid annulus peak systolic velocity (S’). Severity for each parameter was delineated based on ASE guidelines (table 1). Intervention data was also collected. Results Among patients with normal RVSP, 27.27% underwent intervention for their PE compared to 60% for the severe group. 12.50% of patients with normal TAPSE underwent intervention compared to 80% in the severe group. Among patients with normal TRV 53.85% underwent PE intervention while only 50% underwent procedures among the severe group. Patients with normal S’ did not undergo any intervention compared to 100% of the patients in the severe S’ group. (Table1). Intervention data was also collected. Conclusions A higher percentage of patients in the severe right heart dysfunction groups underwent intervention compared to patients in the normal groups, with the exception of TRV, which showed that more patients in the normal group underwent intervention compared to the severe group. Elucidating the relationship between severity grading on right heart dysfunction on echocardiogram and rates of intervention may help guide indications for earlier intervention. This abstract is funded by: None
Caton et al. (Fri,) conducted a observational in Pulmonary embolism (n=40). Echocardiographic grading of right heart dysfunction severity vs. Normal vs severe right heart dysfunction parameters was evaluated on Rate of pulmonary embolism intervention. Severe right heart dysfunction on echocardiogram was associated with higher rates of pulmonary embolism intervention compared to normal parameters, except for tricuspid regurgitation peak velocity.