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.

Basic information

Original name

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

Authors

VINDIŠ, David (203 Czech Republic), Martin HUTYRA (203 Czech Republic, guarantor), Daniel ŠAŇÁK (203 Czech Republic), Michal KRÁL (203 Czech Republic), Eva ČECHÁKOVÁ (203 Czech Republic), Jana ZAPLETALOVÁ (203 Czech Republic), Simona LITTNEROVÁ (203 Czech Republic, belonging to the institution), Tomáš ADAM (203 Czech Republic), Jan PŘEČEK (203 Czech Republic) and Miloš TÁBORSKÝ (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/18:00104656

Organization unit

Faculty of Medicine

DOI

UT WoS

000429583200001

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 10/2/2019 19:24, Soňa Böhmová

Abstract

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.