title: [Prognostic value of transthoracic echocardiography in hemodynamically stable patients with acute symptomatic pulmonary embolism].
abstract: 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.
authors.affiliation: Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España. djc_69_98@yahoo.com
authors.forename: David
authors.initials: D
authors.lastname: Jiménez
authors.forename: Carlos
authors.initials: C
authors.lastname: Escobar
authors.forename: David
authors.initials: D
authors.lastname: Martí
authors.forename: Gema
authors.initials: G
authors.lastname: Díaz
authors.forename: Rafael
authors.initials: R
authors.lastname: Vidal
authors.forename: Dolores
authors.initials: D
authors.lastname: Taboada
authors.forename: Javier
authors.initials: J
authors.lastname: Ortega
authors.forename: José Luis
authors.initials: JL
authors.lastname: Moya
authors.forename: Vicencio
authors.initials: V
authors.lastname: Barrios
authors.forename: Antonio
authors.initials: A
authors.lastname: Sueiro
mesh_terms: 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