Chest
Original ResearchPulmonary HypertensionProspective Evaluation of Right Ventricular Function and Functional Status 6 Months After Acute Submassive Pulmonary Embolism: Frequency of Persistent or Subsequent Elevation in Estimated Pulmonary Artery Pressure
Section snippets
Materials and Methods
This study was approved by the Institutional Review Board and Privacy Board at Carolinas Medical Center, a large, urban academic hospital in Charlotte, NC. We prospectively enrolled ED patients and hospital inpatients with confirmed PE from January 2002 until February 2005.
Results
We enrolled 210 patients (age range, 18 to 87 years) from January 2002 to May 2005 (Fig 1). The mean time between the initiation of heparin therapy and the performance of the echocardiogram was 13 ± 1 h. Ten patients were excluded from the study shortly after enrollment because of the inability to obtain an echocardiogram (n = 3) or an over-read of the CT angiogram such that the final, written interpretation indicated no evidence of acute PE (n = 7). The per-protocol study cohort thus included
Discussion
This study extends the current knowledge about the expected course of echocardiographically estimated RV function and pressure after acute submassive PE in patients treated with standard anticoagulation. We measured the change in echocardiographic measurements of RV function and estimated the RVSP at diagnosis and 6 months thereafter in a cohort of 200 patients with clearly defined acute submassive PE. All 200 patients, 21 of whom had their treatment escalated to include alteplase in response
Acknowledgments
Author contributions: Dr. Kline wrote the study protocol, obtained funding, collected and analyzed the data, and wrote the article. Dr. Steuerwald collected and analyzed the data, performed search procedures and structured the data extraction for Table 5, and assisted in editing the revisions of the article. Dr. Marchick assisted with the data analysis, writing the first draft, and editing the revisions of the article. Dr. Hernandez-Nino collected and analyzed the data. Dr. Rose helped to write
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Funding/Support: This work was supported by the National Heart, Lung, and Blood Institute [grant R01HL074384] (to Dr. Kline).
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