Usefulness of regional myocardial performance index to diagnose pulmonary embolism in patients with echocardiographic signs of pulmonary hypertension.
In this study, myocardial performance index (MPI) was used to identify pulmonary embolism (PE) in patients with echocardiographic signs of pulmonary hypertension. One hundred patients with echocardiographic signs of pulmonary hypertension were enrolled in this study after informed consent was obtained. All patients underwent multidetector-row computed tomography of the chest, and PE was found in 50 patients. Another 100 patients without any cardiopulmonary distress or echocardiographic signs of pulmonary hypertension served as the control group. All cohorts were enrolled after the exclusion of (1) any rhythm other than sinus rhythm; (2) complete bundle branch block; (3) ischemic heart disease proved by stress test, perfusion scan, or coronary angiography; (4) a left ventricular (LV) ejection fraction <50%; and (5) inadequate echocardiograms. Routine echocardiography and tissue Doppler imaging were performed, including the MPIs of the right and left ventricles. The right ventricular (RV) MPI was significantly higher in patients with PE than in others (p <0.0001). Patients without PE had concordant changes in the RV and LV MPIs. In patients with acute PE, the RV MPI became higher, but the LV MPI was relatively constant. Using the RV MPI divided by the LV MPI (the V index), PE could be distinguished in patients with echocardiographic signs of pulmonary hypertension. By receiver-operating characteristic curve analysis, the V index >1.2 identified PE with sensitivity of 82% and specificity of 83%. In conclusion, the V index is a useful parameter to assess the possibility of PE in patients with echocardiographic signs of pulmonary hypertension.
Hsiao
Shih-Hung
SH
Cardiovascular Center, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. a841120@ms3.hinet.net
Yang
Shu-Hsin
SH
Wang
Wen-Chin
WC
Lee
Chiu-Yen
CY
Lin
Shih-Kai
SK
Liu
Chun-Peng
CP
D000368:Aged; D015150:Echocardiography, Doppler; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*; D012372:ROC Curve; D016276:Ventricular Function