[Study of the echocardiographic diagnosis of acute pulmonary thromboembolism and risk factors for venous thromboembolism].
OBJECTIVE
To identify the relationship of risk factors for atherosclerosis with venous thromboembolism (VTE) and the utility of transthoracic echocardiography in acute pulmonary thromboembolism (APTE).


METHODS
In 75 patients with VTE (VTE group), 101 patients with suspected VTE (N group), and 50 control subjects (control group), the frequency of atherosclerosis risk factors such as hyperlipidemia, obesity, hypertension, smoking, and diabetes mellitus and the number of risk factors were evaluated. Transthoracic echocardiographic findings such as tricuspid regurgitation, right ventricular dilation, pulmonary hypertension, and right ventricular dysfunction were evaluated in 15 patients with APTE (APTE group) and 38 patients in the N group (NC group).


RESULTS
The incidence of hyperlipidemia in the VTE group was statistically higher than that in the control group (odds ratio 2.16, 95% confidence interval 1.43-3.08). Additionally, the incidence of obesity was higher in the VTE and N groups than in the control group (odds ratio was 2.76, 95% confidence interval 1.67-4.37). Risk factors other than obesity and hyperlipidemia and the number of risk factors were not significant. The incidence of tricuspid regurgitation, right ventricular dilation, and pulmonary hypertension in APTE was statistically greater than that in NC group. Right ventricular dilation and right ventricular dilation + tricuspid regurgitation are reliable findings in echocardiography. However, even combining with tricuspid regurgitation, right ventricular dilation is insufficient to identify or screen patients with APTE.


CONCLUSIONS
Hyperlipidemia and obesity may be risk factors for VTE. However, obese patients can manifest similar findings to VTE. Although transthoracic echocardiograpghy is not recommended as a diagnostic or screening test in APTE, it should be used as an ancillary test.
Hirohashi
Tsutomu
T
Department of Cardiovascular Center, Toho University School of Medicine, Sakura Hospital, Miyashita 564-1, Shimoshizu, Sakura, Chiba 285-0841.
Yoshinaga
Kunio
K
Sakurai
Takeshi
T
Kanai
Masahito
M
Shimizu
Kazuhiro
K
Sugiyama
Yuko
Y
Noike
Hirofumi
H
Ohsawa
Hidefumi
H
Sakuragawa
Hiroshi
H
Tokuhiro
Keiichi
K
Takahashi
Osamu
O
Tomaru
Takanobu
T
D000208:Acute Disease; D004452:Echocardiography; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D006976:Hypertension, Pulmonary / Q000150:complications; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013923:Thromboembolism / Q000209:etiology*; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D020246:Venous Thrombosis / Q000209:etiology*