Skip Navigation


European Heart Journal Advance Access originally published online on May 21, 2008
European Heart Journal 2008 29(12):1569-1577; doi:10.1093/eurheartj/ehn208
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
29/12/1569    most recent
ehn208v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (5)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Sanchez, O.
Right arrow Articles by Meyer, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sanchez, O.
Right arrow Articles by Meyer, G.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review

Olivier Sanchez1,2,*, Ludovic Trinquart3,4, Isabelle Colombet2,5,6, Pierre Durieux2,5,6, Menno V. Huisman8, Gilles Chatellier2,5,6 and Guy Meyer1,2,7

1 APHP, Division of Respiratory and Intensive Care Medicine, Georges Pompidou European Hospital, 75015 Paris, France
2 Université Paris Descartes, 75006 Paris, France
3 APHP, Epidemiology and Clinical Research Unit, Georges Pompidou European Hospital, 75015 Paris, France
4 INSERM, CIE4, 75015 Paris, France
5 APHP, Hospital Informatics Department, Georges Pompidou European Hospital, 75015 Paris, France
6 INSERM, UMR-S 872, eq. 20, 75006 Paris, France
7 INSERM U 765, 75015 Paris, France
8 Section of Clinical Vascular Medicine, Department of General Internal Medicine/Endocrinology, Leiden University Medical Center, Albinusdreef 2, Room C4-68, 2300 RC Leiden, The Netherlands

Received 29 December 2007; revised 22 April 2008; accepted 24 April 2008; online publish-ahead-of-print 21 May 2008.

* Corresponding author. Tel: +33 1 56 09 34 61, Fax: +33 1 56 09 32 55, Email: olivier.sanchez{at}egp.aphp.fr

Aims: To determine the prognostic value of right ventricular (RV) dysfunction assessed by echocardiography or spiral computed tomography (CT), or by increased levels of cardiac biomarkers [troponin, brain natriuretic peptide (BNP) and pro-BNP] in patients with haemodynamically stable pulmonary embolism (PE).

Methods and results: We included all studies published between January 1985 and October 2007 estimating the relationship between echocardiography, CT or cardiac biomarkers and the risk of death in patients with haemodynamically stable PE. Twelve of 722 potentially relevant studies met inclusion criteria. The unadjusted risk ratio of RV dysfunction as assessed by echocardiography (five studies) or by CT (two studies) for predicting death was 2.4 [95% confidence interval (CI) 1.3–4.4]. The unadjusted risk ratio for predicting death was 9.5 (95% CI 3.2–28.6) for BNP (five studies), 5.7 (95% CI 2.2–15.1) for pro-BNP (two studies) and 8.3 (95% CI 3.6–19.3) for cardiac troponin (three studies). Threshold values differed substantially between studies for all markers.

Conclusion: RV dysfunction assessed by CT, echocardiography, or by cardiac biomarkers are all associated with an increased risk of mortality in patients with haemodynamically stable PE. These findings should be interpreted with caution because of the clinical and methodological diversity of studies.

Key Words: Pulmonary embolism • Prognosis • Right ventricular dysfunction • BNP • Echocardiography


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 ChestHome page
J. A. Kline, M. T. Steuerwald, M. R. Marchick, J. Hernandez-Nino, and G. A. Rose
Prospective 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
Chest, November 1, 2009; 136(5): 1202 - 1210.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
J-C Lega, Y Lacasse, L Lakhal, and S Provencher
Natriuretic peptides and troponins in pulmonary embolism: a meta-analysis
Thorax, October 1, 2009; 64(10): 869 - 875.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
O. Sanchez, B. Planquette, and G. Meyer
Update on acute pulmonary embolism
Eur. Respir. Rev., September 1, 2009; 18(113): 137 - 147.
[Full Text] [PDF]

Home page
 QJMHome page
A.R. Akram, G.W. Cowell, L.J.A. Logan, M. Macdougall, J.H. Reid, J.T. Murchison, and A.J. Simpson
Clinically suspected acute pulmonary embolism: a comparison of presentation, radiological features and outcome in patients with and without PE
QJM, June 1, 2009; 102(6): 407 - 414.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
S. Konstantinides
Acute Pulmonary Embolism
N. Engl. J. Med., December 25, 2008; 359(26): 2804 - 2813.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
D. Jimenez
Right ventricular dysfunction for prognosis in haemodynamically stable patients with acute symptomatic pulmonary embolism
Eur. Heart J., November 1, 2008; 29(21): 2696 - 2697.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.