Right Atrial Size and 30-Day Mortality in Normotensive Patients with Pulmonary EmbolismJosé Luís Lobo1, Vanessa Zorrilla1, José A Nieto 2, Vicente Gomez3, Ferrán García-Bragado4, Teresa Bueso5, Andrei Braester6, Manuel Monreal7* and Riete investigators8
- *Corresponding Author:
- Manuel Monreal
Department of Internal Medicine
Hospital Universitario Germans Trias i Pujol
08916 Badalona (Barcelona), Spain,
E-mail: [email protected]
Received date: September 25, 2014; Accepted date: November 17, 2014; Published date: November 21, 2014
Citation: Lobo JL, Zorrilla V, Nieto AJ, Gomez V, García-Bragado F, et al. (2014) Right Atrial Size and 30-Day Mortality in Normotensive Patients with Pulmonary Embolism. J Pulm Respir Med 4:218. doi:10.4172/2161-105X.1000218
Copyright: © 2014 Lobo JL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: The role of right atrial (RA) dilatation for predicting mortality in normotensive patients with pulmonary embolism (PE) has not been thoroughly studied.
Methods: We used the RIETE Registry data to evaluate the prognostic value of RA dilatation (visual estimate) on transthoracic echocardiography (ETT) in patients with acute PE presenting with systolic blood pressure levels ≥90 mm Hg.
Results: As of April 2013, 7,677 normotensive patients with acute PE underwent ETT within the first 48 hours. Of these, 2,268 (29.5%) had RA dilatation. At 30 days, 212 patients (2.76%) died, of whom 59 (0.77%) died of confirmed PE. Patients with RA dilatation had a 6-fold higher rate of fatal PE (1.85% vs. 0.31%; odds ratio [OR]: 5.98; 95% CI: 3.44-10.8) and a 2-fold higher all-cause mortality (4.32% vs. 2.11%; OR: 2.10; 95% CI: 1.59-2.76) compared with those without RA dilatation. On multivariable analysis, RA dilatation independently predicted fatal PE (relative risk [RR]: 3.71; 95% CI: 1.68-8.17), while right ventricle hypokinesis did not (RR: 1.36; 95% CI: 0.66-2.80).
Conclusions: Among normotensive patients with acute PE, RA dilatation on ETT independently predicted fatal PE at 30 days.