Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism
Assessment of the right ventricular (RV) function by echocardiography in patients with pulmonary thromboembolism (PTE) is complex and frequently qualitative. Tissue Doppler has been used for the semiquantitative assessment of this chamber, although with some limitations. To evaluate RV function in P...
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| Veröffentlicht in: | Arquivos brasileiros de cardiologia 2013-06, Vol.100 (6), p.524-530 |
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| creator | Rodrigues, Ana Clara Tude Cordovil, Adriana Monaco, Claudia Guimarães, Laise Cury, Alexandre Naccarato, Gustavo A F Lira-Filho, Edgar Fischer, Claudio Henrique Vieira, Marcelo Luiz Campos Morhy, Samira |
| description | Assessment of the right ventricular (RV) function by echocardiography in patients with pulmonary thromboembolism (PTE) is complex and frequently qualitative. Tissue Doppler has been used for the semiquantitative assessment of this chamber, although with some limitations.
To evaluate RV function in PTE using tissue-Doppler echocardiography, in addition to atrial natriuretic peptide (BNP).
Patients with PTE were studied using tissue-Doppler echocardiography and BNP up to 24 hours after diagnosis; myocardial velocities (s'), strain, strain rate and RV myocardial performance index were obtained. RV dysfunction was diagnosed by chamber hypokinesia, abnormal septal motion and a RV/LV ratio >1. According to their BNP levels, the patients were divided into Group I, BNP < 50 pg/mL and Group II, BNP > 50 pg/mL.
Of 118 patients, 100 (60 men, age = 55 ± 17 years) were analyzed; RV dysfunction was observed in 28%, more frequently in group II (19 vs. 9 patients, p < 0.001). Patients in group II were older (64 ± 19 vs. 50 ± 15 years), and had lower s' velocity (10.5 ± 3.5 vs. 13.2 ± 3.1 cm/s), and higher pulmonary pressure (48 ± 11 vs. 35 ± 11 mmHg), p < 0.001. The cut-off point of s' for RV dysfunction was 10.8 cm/s (specificity = 85%, sensitivity = 54%), with moderate correlation between BNP and s' wave (r = -0.39).
In PTE, RV dysfunction on echocardiography is accompanied by BNP elevation; although tissue-Doppler imaging adequately confirms the presence of RV dysfunction, it has a limited sensitivity for this diagnosis. |
| doi_str_mv | 10.5935/abc.20130099 |
| format | Article |
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To evaluate RV function in PTE using tissue-Doppler echocardiography, in addition to atrial natriuretic peptide (BNP).
Patients with PTE were studied using tissue-Doppler echocardiography and BNP up to 24 hours after diagnosis; myocardial velocities (s'), strain, strain rate and RV myocardial performance index were obtained. RV dysfunction was diagnosed by chamber hypokinesia, abnormal septal motion and a RV/LV ratio >1. According to their BNP levels, the patients were divided into Group I, BNP < 50 pg/mL and Group II, BNP > 50 pg/mL.
Of 118 patients, 100 (60 men, age = 55 ± 17 years) were analyzed; RV dysfunction was observed in 28%, more frequently in group II (19 vs. 9 patients, p < 0.001). Patients in group II were older (64 ± 19 vs. 50 ± 15 years), and had lower s' velocity (10.5 ± 3.5 vs. 13.2 ± 3.1 cm/s), and higher pulmonary pressure (48 ± 11 vs. 35 ± 11 mmHg), p < 0.001. The cut-off point of s' for RV dysfunction was 10.8 cm/s (specificity = 85%, sensitivity = 54%), with moderate correlation between BNP and s' wave (r = -0.39).
In PTE, RV dysfunction on echocardiography is accompanied by BNP elevation; although tissue-Doppler imaging adequately confirms the presence of RV dysfunction, it has a limited sensitivity for this diagnosis.</description><identifier>ISSN: 0066-782X</identifier><identifier>EISSN: 1678-4170</identifier><identifier>DOI: 10.5935/abc.20130099</identifier><identifier>PMID: 23657266</identifier><language>eng ; por</language><publisher>Brazil</publisher><subject>Adult ; Aged ; Atrial Natriuretic Factor - blood ; Blood Pressure - physiology ; Echocardiography, Doppler - methods ; Female ; Heart Rate - physiology ; Humans ; Male ; Middle Aged ; Observer Variation ; Pulmonary Embolism - blood ; Pulmonary Embolism - physiopathology ; ROC Curve ; Ventricular Dysfunction, Right - blood ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - physiopathology</subject><ispartof>Arquivos brasileiros de cardiologia, 2013-06, Vol.100 (6), p.524-530</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27915,27916</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23657266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodrigues, Ana Clara Tude</creatorcontrib><creatorcontrib>Cordovil, Adriana</creatorcontrib><creatorcontrib>Monaco, Claudia</creatorcontrib><creatorcontrib>Guimarães, Laise</creatorcontrib><creatorcontrib>Cury, Alexandre</creatorcontrib><creatorcontrib>Naccarato, Gustavo A F</creatorcontrib><creatorcontrib>Lira-Filho, Edgar</creatorcontrib><creatorcontrib>Fischer, Claudio Henrique</creatorcontrib><creatorcontrib>Vieira, Marcelo Luiz Campos</creatorcontrib><creatorcontrib>Morhy, Samira</creatorcontrib><title>Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism</title><title>Arquivos brasileiros de cardiologia</title><addtitle>Arq Bras Cardiol</addtitle><description>Assessment of the right ventricular (RV) function by echocardiography in patients with pulmonary thromboembolism (PTE) is complex and frequently qualitative. Tissue Doppler has been used for the semiquantitative assessment of this chamber, although with some limitations.
To evaluate RV function in PTE using tissue-Doppler echocardiography, in addition to atrial natriuretic peptide (BNP).
Patients with PTE were studied using tissue-Doppler echocardiography and BNP up to 24 hours after diagnosis; myocardial velocities (s'), strain, strain rate and RV myocardial performance index were obtained. RV dysfunction was diagnosed by chamber hypokinesia, abnormal septal motion and a RV/LV ratio >1. According to their BNP levels, the patients were divided into Group I, BNP < 50 pg/mL and Group II, BNP > 50 pg/mL.
Of 118 patients, 100 (60 men, age = 55 ± 17 years) were analyzed; RV dysfunction was observed in 28%, more frequently in group II (19 vs. 9 patients, p < 0.001). Patients in group II were older (64 ± 19 vs. 50 ± 15 years), and had lower s' velocity (10.5 ± 3.5 vs. 13.2 ± 3.1 cm/s), and higher pulmonary pressure (48 ± 11 vs. 35 ± 11 mmHg), p < 0.001. The cut-off point of s' for RV dysfunction was 10.8 cm/s (specificity = 85%, sensitivity = 54%), with moderate correlation between BNP and s' wave (r = -0.39).
In PTE, RV dysfunction on echocardiography is accompanied by BNP elevation; although tissue-Doppler imaging adequately confirms the presence of RV dysfunction, it has a limited sensitivity for this diagnosis.</description><subject>Adult</subject><subject>Aged</subject><subject>Atrial Natriuretic Factor - blood</subject><subject>Blood Pressure - physiology</subject><subject>Echocardiography, Doppler - methods</subject><subject>Female</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Pulmonary Embolism - blood</subject><subject>Pulmonary Embolism - physiopathology</subject><subject>ROC Curve</subject><subject>Ventricular Dysfunction, Right - blood</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><issn>0066-782X</issn><issn>1678-4170</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtLw0AUhQdRbK3uXMssXRidR-aRpdQnFARREFyEycxtO5Jk4kwi9N8baevqwuHjcO6H0Dkl16Lg4sZU9poRygkpigM0pVLpLKeKHKIpIVJmSrOPCTpJ6YsQxhQXx2jCuBSKSTlFn69-te7xD7R99HaoTcQmJUipGRNcbXDvUxoguwtdV0PEYNfBmuh8WEXTrTfYt9jYoQfcDXUTWhM3GJoq1D41p-hoaeoEZ7s7Q-8P92_zp2zx8vg8v11kllHZZ8zl2hqnlNW0kM4RyYlZ5oJLpisonGAkl4oxp8cPQeVSE20K6xwYIURV8Rm63PZ2MXwPkPqy8clCXZsWwpBKmnPCCylzOaJXW9TGkFKEZdlF34yjS0rKP53lqLPc6xzxi13zUDXg_uG9P_4LISFxzQ</recordid><startdate>20130601</startdate><enddate>20130601</enddate><creator>Rodrigues, Ana Clara Tude</creator><creator>Cordovil, Adriana</creator><creator>Monaco, Claudia</creator><creator>Guimarães, Laise</creator><creator>Cury, Alexandre</creator><creator>Naccarato, Gustavo A F</creator><creator>Lira-Filho, Edgar</creator><creator>Fischer, Claudio Henrique</creator><creator>Vieira, Marcelo Luiz Campos</creator><creator>Morhy, Samira</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130601</creationdate><title>Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism</title><author>Rodrigues, Ana Clara Tude ; Cordovil, Adriana ; Monaco, Claudia ; Guimarães, Laise ; Cury, Alexandre ; Naccarato, Gustavo A F ; Lira-Filho, Edgar ; Fischer, Claudio Henrique ; Vieira, Marcelo Luiz Campos ; Morhy, Samira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c216t-2d48cad77c8196dd0630af453628be9d52046722d8099e746808a9cddea555bb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; por</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Atrial Natriuretic Factor - blood</topic><topic>Blood Pressure - physiology</topic><topic>Echocardiography, Doppler - methods</topic><topic>Female</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Pulmonary Embolism - blood</topic><topic>Pulmonary Embolism - physiopathology</topic><topic>ROC Curve</topic><topic>Ventricular Dysfunction, Right - blood</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodrigues, Ana Clara Tude</creatorcontrib><creatorcontrib>Cordovil, Adriana</creatorcontrib><creatorcontrib>Monaco, Claudia</creatorcontrib><creatorcontrib>Guimarães, Laise</creatorcontrib><creatorcontrib>Cury, Alexandre</creatorcontrib><creatorcontrib>Naccarato, Gustavo A F</creatorcontrib><creatorcontrib>Lira-Filho, Edgar</creatorcontrib><creatorcontrib>Fischer, Claudio Henrique</creatorcontrib><creatorcontrib>Vieira, Marcelo Luiz Campos</creatorcontrib><creatorcontrib>Morhy, Samira</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arquivos brasileiros de cardiologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodrigues, Ana Clara Tude</au><au>Cordovil, Adriana</au><au>Monaco, Claudia</au><au>Guimarães, Laise</au><au>Cury, Alexandre</au><au>Naccarato, Gustavo A F</au><au>Lira-Filho, Edgar</au><au>Fischer, Claudio Henrique</au><au>Vieira, Marcelo Luiz Campos</au><au>Morhy, Samira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism</atitle><jtitle>Arquivos brasileiros de cardiologia</jtitle><addtitle>Arq Bras Cardiol</addtitle><date>2013-06-01</date><risdate>2013</risdate><volume>100</volume><issue>6</issue><spage>524</spage><epage>530</epage><pages>524-530</pages><issn>0066-782X</issn><eissn>1678-4170</eissn><abstract>Assessment of the right ventricular (RV) function by echocardiography in patients with pulmonary thromboembolism (PTE) is complex and frequently qualitative. Tissue Doppler has been used for the semiquantitative assessment of this chamber, although with some limitations.
To evaluate RV function in PTE using tissue-Doppler echocardiography, in addition to atrial natriuretic peptide (BNP).
Patients with PTE were studied using tissue-Doppler echocardiography and BNP up to 24 hours after diagnosis; myocardial velocities (s'), strain, strain rate and RV myocardial performance index were obtained. RV dysfunction was diagnosed by chamber hypokinesia, abnormal septal motion and a RV/LV ratio >1. According to their BNP levels, the patients were divided into Group I, BNP < 50 pg/mL and Group II, BNP > 50 pg/mL.
Of 118 patients, 100 (60 men, age = 55 ± 17 years) were analyzed; RV dysfunction was observed in 28%, more frequently in group II (19 vs. 9 patients, p < 0.001). Patients in group II were older (64 ± 19 vs. 50 ± 15 years), and had lower s' velocity (10.5 ± 3.5 vs. 13.2 ± 3.1 cm/s), and higher pulmonary pressure (48 ± 11 vs. 35 ± 11 mmHg), p < 0.001. The cut-off point of s' for RV dysfunction was 10.8 cm/s (specificity = 85%, sensitivity = 54%), with moderate correlation between BNP and s' wave (r = -0.39).
In PTE, RV dysfunction on echocardiography is accompanied by BNP elevation; although tissue-Doppler imaging adequately confirms the presence of RV dysfunction, it has a limited sensitivity for this diagnosis.</abstract><cop>Brazil</cop><pmid>23657266</pmid><doi>10.5935/abc.20130099</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central; Alma/SFX Local Collection; EZB Electronic Journals Library; PubMed Central Open Access |
| subjects | Adult Aged Atrial Natriuretic Factor - blood Blood Pressure - physiology Echocardiography, Doppler - methods Female Heart Rate - physiology Humans Male Middle Aged Observer Variation Pulmonary Embolism - blood Pulmonary Embolism - physiopathology ROC Curve Ventricular Dysfunction, Right - blood Ventricular Dysfunction, Right - diagnostic imaging Ventricular Dysfunction, Right - physiopathology |
| title | Right ventricular assessment by tissue-Doppler echocardiography in acute pulmonary embolism |
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