Abstract
In patients with intermediate-risk pulmonary embolism (PE), time to resolution of echocardiographic right ventricle (RV) dysfunction has not been fully elucidated.
Methods: We used echocardiographic data from patients who enrolled the placebo arm in the AINEP clinical trial. The main objective of this substudy was to analyse the frequency of normalization of RV function at 48 hours and 7 days after initiation of anticoagulant therapy. Echocardiographic parameters included presence or absence of RV dysfunction, diastolic diameter of the RV, ratio between the RV and the left ventricle (LV) diameters, systolic pulmonary arterial pressure, presence or absence of hypokinesia of the RV, and TAPSE.
Results: We included 17 patients with intermediate-risk PE who received anticoagulation plus placebo in the AINEP trial. RV dysfunction was present in 13 patients (76%; P= 0.10) at 48 hours, and in 6 patients (35%; p<0.001) at 7 days after initiation of anticoagulation. Hypokinesis of the RV free wall was still present in 7 patients (41%; P= 0.17) at 48 hours, and in 1 patient at 7 days. The proportion of patients with a RV diastolic diameter >30 mm decreased from 94% at the time of randomization to 71% (P= 0.17) and 35% (p<0.001) at 48 hours and 7 days, respectively. A RV/VI ratio >1 was still present in 71% (P= 0.04) and in 18% (P<0.001) of the patients at 48 hours and 7 days, respectively.
Conclusions: Around 75% of patients with intermediate-risk PE have persistent RV dysfunction 48 hours after initiation of anticoagulant treatment. For patients with intermediate-risk PE, clinicians should not routinely order repeat echocardiograms to monitor response to anticoagulant treatment.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3583.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020