Usefulness of tissue Doppler parameters for identifying pulmonary embolism in patients with signs of pulmonary hypertension.
The objective of this study was to use tissue Doppler parameters to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred fifty patients with echocardiographic signs of pulmonary hypertension were enrolled, 50 of whom had PE on multidetector row computed tomography of the chest. Another 150 patients without cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as a control group. All patients were in sinus rhythm. Routine echocardiography and tissue Doppler imaging were performed. The right ventricular (RV) myocardial performance index (MPI) was obtained during tissue Doppler imaging over the lateral tricuspid annulus. The M index was measured and defined as the peak early diastolic mitral inflow velocity divided by the RV MPI. Statistical analysis was preformed using receiver-operating characteristic curves. Peak early diastolic mitral inflow velocity was significantly less and the RV MPI was significantly greater in patients with PE than in patients without PE (both p values < 0.0001). The RV MPI and the M index were useful in identifying PE in patients with echocardiographic signs of pulmonary hypertension. On statistical analysis, a RV MPI > 0.55 identified PE with a sensitivity of 85% and a specificity of 78%. A M index < 112 had a sensitivity of 92% and a specificity of 92%. In conclusion, the sensitivity and specificity of the RV MPI and the M index to identify PE were excellent. Echocardiography is a useful method to screen for PE.
Hsiao
Shih-Hung
SH
Cardiovascular Center, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. a841120@ms3.hinet.net
Chang
Shu-Mei
SM
Lee
Chiu-Yen
CY
Yang
Shu-Hsin
SH
Lin
Shih-Kai
SK
Chiou
Kuan-Rau
KR
D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D009200:Myocardial Contraction / Q000502:physiology; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012372:ROC Curve; D015203:Reproducibility of Results