Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleYalnız künye2021Time interval between E and E′ waves can predict complicated clinical course in patients with acute pulmonary embolism
Acar, Emrah; Kilicgedik, Alev; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet Fatih; Gokce, Mustafa; Izgi, Ibrahim Akin; Kirma, Cevat
Purpose Acute pulmonary embolism is a life-threatening cardiothoracic emergency leading to right ventricle systolic and diastolic dysfunction. In the present study, we investigated the right ventricle diastolic function and its predictive value in patients with acute pulmonary embolism. Material and methods Were prospectively recruited in this study 621 patients diagnosed with acute pulmonary embolism between December 2015 and June 2019. Among them, 173 were excluded, leaving 448 patients for follow-up. Transthoracic echocardiography was performed for the evaluation of the right ventricle systolic and diastolic indices. At 30-day follow-up, the patients were allocated either into the benign or in the complicated clinical course group. Results The group with complicated clinical course had higher value of pulmonary artery systolic pressure (PASP), right/left ventricle diameter ratio, E-wave velocity, E/A ratio, A ' wave velocity, E/E ' ratio, and time interval between E and E ' waves (P < .05), but lower values of tricuspid annular plane systolic excursion, A-wave velocity, isovolumetric relaxation time, deceleration time, E ', and E '/A ' (P < .05). Complicated clinical course was associated with shorter isovolumetric relaxation time (r = .564, P < .001), E/E ' (r = .495, P < .001), and TE-E ' (r = .596, P < .001). Receiver operator characteristic curve analysis showed that TE-E ' had the largest area under curve (TE-E ' 0.82, IVRT 0.77, E/E ' 0.72). A cut-off value of TE-E ' = 70 milliseconds had an 81.1% sensitivity and 71.4% specificity for the prediction of the complicated clinical course. Conclusion The assessment of the right ventricle diastolic function could predict the complicated clinical course in patients with acute pulmonary embolism.
- MakaleYalnız künye2020Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism
Acar, Emrah; Izci, Servet; Inanir, Mehmet; Yilmaz, Mehmet F.; Izgi, Ibrahim A.; Gokce, Mustafa; Kirma, Cevat
Purpose Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status. Methods We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows. Result A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI >= 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD. Conclusion HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE.