[The impact of right ventricular dysfunction on the clinical outcome of normotensive patients with pulmonary embolism].

OBJECTIVE

To investigate the prevalence and clinical outcome of right ventricular (RV) dysfunction among normotensive PE patients.

METHODS

Inclusion criteria included: (1) Confirmed PE at Sir Run Run Shaw Hospital from January 2001 to December 2004. (2) Normotensive. (3) Echocardiography done before therapy. RV dysfunction was assessed with echocardiography in the presence of one or more of the following criteria: RV dilatation, pulmonary hypertension as evidenced by pulmonary artery systolic pressure>30 mm Hg, pulmonary artery mean pressure>20 mm Hg and tricuspid regurgitant velocity>2.8 m/s. The clinical outcome of these two groups normotensive PE patients with and without RV dysfunction was analyzed.

RESULTS

57 cases of normotensive PE were included in this study. 27 of the 57 patients were judged to have RV dysfunction. There was no difference in age, gender, prevalence of deep venous thrombosis (DVT), cancer or other risk factors in these two groups. In the group with RV dysfunction, 5 patients (19%) died as a result of PE. In comparison, in the group without RV dysfunction, only one patient died related to bladder cancer with multiple brain metastasis, so none of the patients of this group died directly related to PE. After therapy, 22 patients of this group became better and RV function also improved in short-term.

CONCLUSIONS

The mortality related to PE in normotensive patients with RV dysfunction is significantly higher than those without. In patients with PE, echocardiography is quite useful because it can often help to detect RV dysfunction which is a significantly high risk of death. After therapy, RV function of normotensive patients with PE will improve in short-term. Echocardiography is an important means of evaluating of therapeutic outcome in pulmonary embolism.