In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

Comment on right ventricle assessment in patients with pulmonary embolism at low risk for death based on clinical models: an individual patient data meta-analysis

Clinical
ESC Working Groups

There is an ongoing discussion on potential prognostic value of assessment of right ventricular dysfunction  (RVD) in low risk patients with acute pulmonary embolism (PE)  who are  are candidates for home treatment or short-hospital stay.  Dr Becattini tried to solve this  challenge  and  aimed at determining whether the  RVD assessment or elevated troponin improves identification of low-risk patients over clinical models alone. Thereore, they performend very elegant meta-analysis of pooled  individual patient (IPDMA) data of >5000 subjects  included into 18   studies assessing the relationship between RVD or elevated troponin and shortterm mortality in patients with acute PE at low risk for death based on clinical models (Pulmonary Embolism Severity Index, simplified Pulmonary Embolism Severity Index or Hestia) .  The primary outcome of IPDMA was short-term death defined as death occurring in hospital or within 30 days.  Short-term mortality was 0.7% [95% CI 0.4–1.3]. RVD at echocardiography, computed tomography or B-type natriuretic peptide  was associated with increased risk for short-term death (1.5 vs. 0.3%; OR 4.81, 95% CI 1.98–11.68), death within 3 months  and PE-related death (1.1 vs. 0.04%; OR 22.9, 95% CI 2.89–181).  Interestingly,  RVD at echocardiography and BNP or NT-proBNP levels were the most reliable predictors of death in low  rsik PE  patients. Indeed,  this study can help clinicians in decision making, beacuse  RVD assessment, mainly by BNP/NT-proBNP or echocardiography, should improve identification of low-risk PE  patients  and facilitate  their outpatient management or short hospital stay.

References


European Heart Journal (2021) 42, 3190–3199

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

Contact us

ESC Working Group on Pulmonary Circulation & Right Ventricular Function

European Society of Cardiology

European Heart House
Les Templiers
2035 Route des Colles
CS 80179 Biot

06903, Sophia Antipolis, FR

Tel: +33.4.92.94.76.00