title: Right ventricular isovolumic acceleration in acute pulmonary embolism.
abstract: OBJECTIVE
  In this study, we examined the role of isovolumic acceleration (IVA) measured with right ventricle (RV) tissue Doppler imaging (TDI) to predict the presence of acute pulmonary embolism (APE) in hemodynamically stable patients with clinical suspicion of APE.
  
  
  METHODS
  This study included 25 hemodynamically stable (systolic blood pressure >90 mmHg) patients diagnosed with APE for the first time. Twenty-five subjects with similar demographic characteristics in whom APE was excluded due to preexisting clinical suspicion were also enrolled as the control group. All control group subjects were enrolled after proved to have no evidence of APE on imaging. Both groups were compared with respect to RV-IVA measured with TDI in addition to conventional echocardiographic parameters.
  
  
  RESULTS
  Among the echocardiography parameters, only RV-IVA was impaired in patients with hemodynamically stable APE compared to controls (2.85 [1.37-6.42] m/sec(2) vs. 3.32 [2.24-6.52] m/sec(2) , respectively; P = 0.02). A receiver operating characteristic (ROC) analysis was performed to determine the RV-IVA value to predict clinically suspected APE. A cutoff level of 3.22 m/sec(2) had a sensitivity of 64% and a specificity of 60%; a cutoff level of 3.17 m/sec(2) had a sensitivity of 64% and a specificity of 64%; and a cutoff level of 3.10 m/sec(2) had a sensitivity of 60% and specificity of 64% (ROC area under curve: 0.691, 95% CI: 0.543-0.839, P = 0.02).
  
  
  CONCLUSIONS
  Results of our study suggest that RV-IVA may be a useful parameter to detect subtle alterations in RV and may predict the presence of APE in hemodynamically stable patients.
authors.affiliation: Cardiology Department, Karadeniz Eregli State Hospital, Zonguldak, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Cetiner
authors.forename: Muhammet Rasit
authors.initials: MR
authors.lastname: Sayin
authors.forename: Nesligul
authors.initials: N
authors.lastname: Yildirim
authors.forename: Turgut
authors.initials: T
authors.lastname: Karabag
authors.forename: Sait Mesut
authors.initials: SM
authors.lastname: Dogan
authors.forename: Emrah
authors.initials: E
authors.lastname: Kucuk
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aydin
mesh_terms: D000054:Acceleration; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: acute pulmonary embolism; echocardiography; isovolumic acceleration; right ventricle