ArticleCardiovascular ultrasound2013
Right atrial to left atrial area ratio on early echocardiography predicts long-term survival after acute pulmonary embolism.
Article in Cardiovascular ultrasound, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic models in acute pulmonary embolism: a systematic review and meta-analysis.BMJ open · 2016Pooled it
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- Hypertensive Heart Disease: A Narrative Review Series-Part 2: Macrostructural and Functional Abnormalities.Journal of clinical medicine · 2023Review
- Role of surgical embolectomy in the management of acute massive and submassive pulmonary embolism in the setting of a small island developing state.Journal of surgical case reports · 2023Article
- Measuring of strain parameters reflects changes of right ventricular function before and after thrombolytic therapy in patients with acute pulmonary embolism.The international journal of cardiovascular imaging · 2022Article
- Echocardiographic predictors of mortality in intermediate-risk pulmonary embolism.Internal and emergency medicine · 2022Article
- Progressive right ventricular dysfunction and exercise impairment in patients with heart failure and diabetes mellitus: insights from the T.O.S.CA. Registry.Cardiovascular diabetology · 2022Article
- Prognostic value of right atrial dilation in patients with pulmonary embolism.ERJ open research · 2021Article
- Tricuspid Regurgitation in Adults after Repair of Right Ventricular Outflow Obstructive Lesions.Pediatric cardiology · 2020Article
- Right ventricular speckle tracking strain echocardiography in patients with acute pulmonary embolism.The international journal of cardiovascular imaging · 2020Article
- Early Use of Echocardiography in Patients With Acute Pulmonary Embolism: Findings From the RIETE Registry.Journal of the American Heart Association · 2018Article
- Estimation of right ventricular dysfunction by computed tomography pulmonary angiography: a valuable adjunct for evaluating the severity of acute pulmonary embolism.Journal of thrombosis and thrombolysis · 2017Article
- Article
- Observational
- Baseline Echocardiographic Predictors of Outcomes in Low-to-intermediate Risk Acute Pulmonary Embolism and Integration with Electrocardiographic Findings: A Systematic Review and Meta-analysis.Journal of cardiovascular echographyArticle
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5 authors.
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Abstract
backgroundCurrent guidelines recommend that transthoracic echocardiography (TTE) should be performed for acute risk stratification following acute pulmonary embolism (PE), but it is unclear whether the initial TTE can predict long-term outcome beyond six months. We sought to assess the potential of the initial right atrial (RA) to left atrial (LA) area ratio (RA/LA ratio) on TTE to predict long-term mortality in survivors of submassive PE.
methodsA derivation cohort comprised a previously reported group of 35 consecutive patients with acute PE who were intensively studied by serial TTE at 1, 2, 5 days, 2, 6, 12 and 26 weeks and RA/LA ratio related to long-term outcome. The Day 1 RA/LA ratio findings were then further related to long-term outcome in 158 patients followed for 3.6 ± 2.3 years.
resultsIn the derivation cohort, total mortality was 28.6% (n = 10) following a mean (±standard deviation) follow-up of 4.3 ± 1.9 years. The RA/LA ratio was highly dynamic, being increased at day 1, but normalised rapidly within 2-5 days of presentation and this was most marked amongst long-term non-survivors. A RA/LA ratio > 1.0 on day 1 was independently associated with a three-fold increase in long-term mortality on Kaplan-Meier analysis. Pooled analysis of 158 patient indicated that age, Charlson Comorbidity Index (CCI), simplified Pulmonary Embolism Severity Score (PESI), troponin T, day 1 RA/LA Ratio and pulmonary arterial systolic pressure (PASP) were univariate predictors of long-term mortality. Multivariate analysis identified Day 1 RA/LA Ratio (HR 1.7 per 10% increase, p = 0.002), CCI (HR 2.2 per 1 unit increase, p = 0.004) and age (HR 1.1, p = 0.03) as the only independent predictors of long-term mortality.
conclusionA RA/LA Ratio >1.0 at presentation with acute PE was associated with a three-fold increased risk of long-term mortality. The RA/LA ratio on presentation with an acute PE is a simple, novel predictor of long-term survival.
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