title: Outcome of patients with right heart thrombi: the Right Heart Thrombi European Registry.
abstract: Our aim was the assessment of the prognostic significance of right heart thrombi (RiHT) and their characteristics in pulmonary embolism in relation to established prognostic factors.138 patients (69 females) aged (mean±sd) 62±19 years with RiHT were included into a multicenter registry. A control group of 276 patients without RiHT was created by propensity scoring from a cohort of 963 contemporary patients. The primary end-point was 30-day pulmonary embolism-related mortality; the secondary end-point included 30-day all-cause mortality. In RiHT patients, pulmonary embolism mortality was higher in 31 patients with systolic blood pressure <90 mmHg than in 107 normotensives (42% versus 12%, p=0.0002) and was higher in the 83 normotensives with right ventricular dysfunction (RVD) than in the 24 normotensives without RVD (16% versus 0%, p=0.038). In multivariable analysis the simplified Pulmonary Embolism Severity Index predicted mortality (hazard ratio 2.43, 95% CI 1.58-3.73; p<0.0001), while RiHT characteristics did not. Patients with RiHT had higher pulmonary embolism mortality than controls (19% versus 8%, p=0.003), especially normotensive patients with RVD (16% versus 7%, p=0.02).30-day mortality in patients with RiHT is related to haemodynamic consequences of pulmonary embolism and not to RiHT characteristics. However, patients with RiHT and pulmonary embolism resulting in RVD seem to have worse prognosis than propensity score-matched controls.
authors.affiliation: Dept of Internal Medicine and Cardiology, The Medical University of Warsaw, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Koć
authors.affiliation: Dept of Internal Medicine and Cardiology, The Medical University of Warsaw, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kostrubiec
authors.affiliation: Dept of Internal Medicine, J. Strus Hospital, Poznan, Poland.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Elikowski
authors.affiliation: Dept of Cardiology, University Hospital of Besancon, Hospital Jean Minjoz, Besancon, EA 3920, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meneveau
authors.affiliation: Clinic of Cardiology and Pneumology, Heart Center, University of Göttingen, Goettingen, Germany.
authors.forename: Mareike
authors.initials: M
authors.lastname: Lankeit
authors.affiliation: Emergency Dept, AOU Careggi, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Grifoni
authors.affiliation: Dept of Internal Medicine and Hypertension and Angiology, The Medical University of Warsaw, Warsaw, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kuch-Wocial
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa, Cardiology Clinic, Spitalul Clinic Judetean de Urgenta Sf. Spiridon, Iasi, Romania.
authors.forename: Antoniu
authors.initials: A
authors.lastname: Petris
authors.affiliation: Dept of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Zaborska
authors.affiliation: Clinical Centre of Serbia, Cardiology Clinic, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Branislav S
authors.initials: BS
authors.lastname: Stefanović
authors.affiliation: The Princess Grace Hospital Centre, Monaco.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hugues
authors.affiliation: Dept of Pulmonary Circulation and Thromboembolic Diseases, Medical Center for Postgraduate Education, ECZ-Otwock, Otwock, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Torbicki
authors.affiliation: Center for Thrombosis and Hemostasis, Gutenberg University of Mainz, Mainz, Germany.
authors.forename: Stavros
authors.initials: S
authors.lastname: Konstantinides
authors.affiliation: Dept of Internal Medicine and Cardiology, The Medical University of Warsaw, Warsaw, Poland piotr.pruszczyk@wum.edu.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Pruszczyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D016022:Case-Control Studies; D004452:Echocardiography; D005060:Europe; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011655:Pulmonary Embolism / Q000401:mortality*; D012042:Registries; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications* / Q000628:therapy*; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*