Prognostic implications of diastolic dysfunction in patients with acute pulmonary embolism

BMC Research Notes

Abraham G Kocheril²  Shobha Shahani³  Indrajeet Mahata³  Snigdha Kola³  Jatin Chhabra⁵  Roop Kaw⁴  Jae Hyung Cho¹ 

[1] Department of Hospital Medicine, Cleveland Clinic, 9500 Euclid Avenue, M2-Annex, Cleveland, OH 44195, USA;Department of Cardiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA;Department of Internal Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA;Department of Hospital Medicine and Outcomes Research Anesthesiology, Cleveland Clinic, Cleveland, OH, USA;Department of Hospital Medicine, Mercy Hospital, Springfield, MO, USA

关键词: Diastolic;    Heart failure;    Echocardiography;    Pulmonary embolism;   

Others  :  1129820
DOI  :  10.1186/1756-0500-7-610

 received in 2014-08-26, accepted in 2014-09-01,  发布年份 2014

【 摘 要 】

Background

A history of congestive heart failure has been used to determine the prognosis in patients with acute pulmonary embolism. Diastolic dysfunction is responsible for the half of congestive heart failure but has not been understood well.

Methods

A total of 205 patients were reported admitted with acute pulmonary embolism from January 2009 to July 2011. We excluded hemodynamically unstable patients who received thrombolytics or underwent thromboembolectomy. We included hemodynamically stable patients who underwent echocardiogram within 72 hours of diagnosis. We reviewed medical records of 107 patients to investigate whether diastolic dysfunction increases in-hospital mortality or adverse clinical outcomes.

Results

Out of 107 patients, 10 patients died during hospitalization with in-hospital mortality rate of 9.3%. Among 84 patients without diastolic dysfunction as assessed by echocardiogram, six patients died with in-hospital mortality rate of 7.1%. Meanwhile, among 23 patients with diastolic dysfunction, four patients died with in-hospital mortality rate of 17.4%. The multivariable adjusted odds ratio was calculated as 2.71, with 95% confidence interval of 0.59 - 12.44.

Conclusions

For hemodynamically stable patients with acute pulmonary embolism, diastolic dysfunction as assessed by echocardiogram could increase in-hospital mortality 2.71 fold, although this was not statistically significant. Further study with a large patient population is needed to determine the statistically significant implications of diastolic dysfunction in patients with acute pulmonary embolism.

【 授权许可】

   
2014 Cho et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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