J 2018

Role of echocardiography and cardiac biomarkers in prediction of in-hospital mortality and long-term risk of brain infarction in pulmonary embolism patients

VINDIŠ, David, Martin HUTYRA, Daniel ŠAŇÁK, Michal KRÁL, Eva ČECHÁKOVÁ et. al.

Základní údaje

Originální název

Role of echocardiography and cardiac biomarkers in prediction of in-hospital mortality and long-term risk of brain infarction in pulmonary embolism patients

Autoři

VINDIŠ, David (203 Česká republika), Martin HUTYRA (203 Česká republika, garant), Daniel ŠAŇÁK (203 Česká republika), Michal KRÁL (203 Česká republika), Eva ČECHÁKOVÁ (203 Česká republika), Jana ZAPLETALOVÁ (203 Česká republika), Simona LITTNEROVÁ (203 Česká republika, domácí), Tomáš ADAM (203 Česká republika), Jan PŘEČEK (203 Česká republika) a Miloš TÁBORSKÝ (203 Česká republika)

Vydání

cor et Vasa, AMSTERDAM, ELSEVIER SCIENCE BV, 2018, 0010-8650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Kód RIV

RIV/00216224:14110/18:00104656

Organizační jednotka

Lékařská fakulta

UT WoS

000429583200001

Klíčová slova anglicky

Pulmonary embolism; Mortality; Brain infarction; Cardiac troponin; Natriuretic peptides; Echocardiography; Magnetic resonance imaging

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 10. 2. 2019 19:24, Soňa Böhmová

Anotace

V originále

Introduction: The aim of prospective study was to evaluate the ability of echocardiography and cardiac biomarkers to predict in-hospital mortality and the risk of brain infarction during a 12-month follow-up period (FUP) with anticoagulation in pulmonary embolism (PE) patients. Methods: Eighty-eight consecutive acute PE patients (39 men, mean age 63 years) were enrolled; 78 underwent baseline echocardiography and brain magnetic resonance imaging (MRI). After a 12-month FUP, 58 underwent brain MRI. In-hospital mortality and the rates of new ischemic brain lesions (IBL) on MRI with clinical ischemic stroke (IS) events were predicted based on echocardiography (patent foramen ovale presence with right-to-left shunt - PFO/RLS; right/left ventricle diameter ratio - RV/LD; tricuspid annulus plane systolic excursion - TAPSE; tricuspid annulus systolic velocity - S-T; pulmonary artery systolic pressure - PASP) and biomarkers results (amino-terminal fragment of brain natriuretic peptide - NT-proBNP and cardiac troponin T - cTnT). Results: Our series involved 88 patients, of whom 11 (12.5%) presented high-risk PE, 24 (27.3%) intermediate-high risk PE, 19 (21.6%) intermediate-low risk PE and 34 (38.6%) patients had low risk PE. Nine patients (10.2%) died during hospitalization including high-risk PE [6/9 (66.6%)] and intermediate-high-risk PE [3/24 (12.5%)]. cTnT [odds ratio (OR) 4.3; 95% confidence interval 0.59-31.3, P = 0.014], NT-proBNP (OR 14.2 [1.5-133.4], P = 0.02), RV/LD = >= 0.79 (OR 36.6 [4.2316.4], P = 0.001), TAPSE (OR 0.55 [0.34-0.92, P = 0.022) and PASP = >= 51.5 mmHg (OR 33.3 [3.8-292.6], P = 0.022) were predictors of in-hospital mortality. Seventeen patients (19.3%) experienced IS (n = 8) or new IBL (n = 9). On multivariate analysis, PFO/RLS (OR 27.1 [3.0-245.3], P = 0.003) and S-T = <= 14.5 cm/s (OR 34.1 [CI 3.4-344.0], P = 0.003) were independent predictors of IS and IBL risk. Conclusions: High blood troponin T, NT-proBNP, RV dilatation/systolic dysfunction and pulmonary hypertension predicted in-hospital mortality. PFO/RLS presence and S-T were predictors of clinically apparent/silent brain infarction. (c) 2017 The Czech Society of Cardiology. Published by Elsevier Sp. z o. o. All rights reserved.