[Prognostic value of transthoracic echocardiography in hemodynamically stable patients with acute symptomatic pulmonary embolism].
OBJECTIVE
To determine the prognostic value of transthoracic echocardiography in hemodynamically stable patients diagnosed with acute symptomatic pulmonary embolism.


METHODS
Hemodynamically stable outpatients diagnosed with acute symptomatic pulmonary embolism at a tertiary university hospital were prospectively included in the study. All patients underwent transthoracic echocardiography within 48 hours of diagnosis. The primary endpoint was all-cause mortality at 1 month.


RESULTS
Right ventricular dysfunction was documented by echocardiography in 86 of the 214 patients (40%) in our series. In the first month of follow-up, 7 patients died--4 with positive echocardiographic findings and 3 with negative findings (odds ratio, 2.0; 95% confidence interval, 0.4-9.3; P=.41). For the primary endpoint, the negative predictive value of transthoracic echocardiography was 98%, the positive predictive value was 5%, and the negative likelihood ratio was 0.7. The negative predictive value was 100% and the positive predictive value was 3% when we analyzed death due to pulmonary embolism only.


CONCLUSIONS
In our setting, transthoracic echocardiography is not useful for prognostic stratification of hemodynamically stable patients with pulmonary embolism.
Jiménez
David
D
Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España. djc_69_98@yahoo.com
Escobar
Carlos
C
Martí
David
D
Díaz
Gema
G
Vidal
Rafael
R
Taboada
Dolores
D
Ortega
Javier
J
Moya
José Luis
JL
Barrios
Vicencio
V
Sueiro
Antonio
A
D000208:Acute Disease; D000368:Aged; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014463:Ultrasonography