Introduction: Transthoracic echocardiogram (TTE) is routinely used for the initial assessment of patients with acute pulmonary embolism (APE). But there is little information about TTE findings in short and mostly long-term APE prognosis. The aim of this study is to identify different TTE parameters in APE related with short and long-term prognosis.
Methods: All patients admitted in our coronary care unit (CCU) with APE from January 2010 to February 2017 were included. We studied the prognostic value of a set of echocardiographic parameters in APE 30-days and 1-year related mortality, and worse New York Heart Association (NYHA) functional class during follow-up in these patients.
Results: 226 patients were included, mean age was 74.5 yo, 57.1% women. TTE at admission was performed in all patients. There was 2.7% 30-day mortality, 15.6% 1-year mortality, and 40% patients were in NYHA class II-IV. After a multivariate analysis the presence of tricuspid regurgitation (TR) at admission was associated with higher 30-day mortality OR 8.10 (95% CI 1.04- 62.87, P=0.045). Inferior Cava Vein(ICV) dilatation with OR 22.09 (95% CI 1.10-448.90, p= 0.044) was associated with 1-year mortality, and right ventricle dilatation (RVd) was related with NYHA class II-IV during follow-up OR 1.13 (95% CI 1.05 - 1.22, p = 0.042) per every millimeter increase in RV diameter .
Conclusion: TTE at admission has demonstrated an important role in short and long-term APE prognosis assessment. We found that presence of TR is associated with higher 30-day mortality; IVC dilatation with higher 1-year mortality and RVd was related with worse NYHA class during follow-up. These parameters can be used to identify those patients with worse prognosis during follow-up