Author, as appears in the article.: Bikdeli B, Lobo JL, Jiménez D, Green P, Fernández-Capitán C, Bura-Riviere A, Otero R, DiTullio MR, Galindo S, Ellis M, Parikh SA, Monreal M, RIETE Investigators

Department: Medicina i Cirurgia

URV's Author/s: Porras Ledantes, Jose Antonio

Keywords: Trends Severity index Right heart thrombi Pulmonary embolism Outcomes Management Echocardiography pulmonary embolism echocardiography

Abstract: © 2018 The Authors. Background—Transthoracic echocardiography (TTE) is often considered for risk stratification of patients with acute pulmonary embolism (PE). We sought to determine the contemporary utilization of early TTE (within 72 hours of PE diagnosis) and explored the association between TTE findings and PE-related mortality. Methods and Results—Data from the RIETE (Registro Informatizado Enfermedad TromboEmbolica) registry, a multicenter registry of consecutive patients with acute PE, were used (2001-July 2017). We used a generalized linear mixed model to determine predictors of early TTE performance. Moreover, the association between 3 TTE variables (right atrial enlargement, right ventricular hypokinesis, and presence of right heart thrombi) and 30-day PE-related mortality was assessed in generalized linear mixed models adjusted for PE severity index, and other comorbidities. Among 35 935 enrollees with acute PE, 15 375 (42.8%) underwent early TTE. There was an increase in early TTE utilization rate over time (P<0.001 for trend). Younger age, female sex, enrollment in countries other than Spain, history of coronary disease, heart failure, atrial fibrillation, tachycardia, and hypotension were the main predictors of early TTE (P<0.01 for all). In multivariable analyses, right atrial enlargement (adjusted odds ratio: 3.74; 95% confidence interval, 2.10-6.66), right ventricular hypokinesis (adjusted odds ratio: 3.11, 95% confidence interval: 1.85-5.21) and right heart thrombi (adjusted odds ratio: 4.39, 95% confidence interval, 1.99-9.71) were associated with increased odds for PErelated mortality. Conclusions—Early TTE is commonly performed for acute PE and utilization rates have increased over time. Right atrial enlargement, right ventricular hypokinesis, and right heart thrombi are predictive of worse outcomes. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02832245.

Thematic Areas: Saúde coletiva Nutrição Medicina ii Medicina i Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 20479980

Author's mail: joseantonio.porras@urv.cat

Author identifier: 0000-0001-6418-1822

Record's date: 2023-02-22

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.ahajournals.org/doi/10.1161/JAHA.118.009042

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of The American Heart Association. 7 (17): e009042-

APA: Bikdeli B, Lobo JL, Jiménez D, Green P, Fernández-Capitán C, Bura-Riviere A, Otero R, DiTullio MR, Galindo S, Ellis M, Parikh SA, Monreal M, RIETE Inv (2018). Early use of echocardiography in patients with acute pulmonary embolism: Findings from the RIETE registry. Journal Of The American Heart Association, 7(17), e009042-. DOI: 10.1161/JAHA.118.009042

Article's DOI: 10.1161/JAHA.118.009042

Entity: Universitat Rovira i Virgili

Journal publication year: 2018

Publication Type: Journal Publications