A retrospective observational study investigating the factors associated with right heart failure in patients with primary acute pulmonary embolism and deep vein thrombosis.
CT pulmonary angiography
deep vein thrombosis
indirect CT venography
pulmonary embolism
right heart failure
ultrasonography
Journal
Journal of general and family medicine
ISSN: 2189-7948
Titre abrégé: J Gen Fam Med
Pays: Japan
ID NLM: 101689875
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
22
03
2019
revised:
13
01
2020
accepted:
04
02
2020
entrez:
4
6
2020
pubmed:
4
6
2020
medline:
4
6
2020
Statut:
epublish
Résumé
The relationship between the risk of right heart failure in primary acute pulmonary embolism after embolization and the residual thrombus sites in the pelvis and lower limbs is not clear. This single-center retrospective observational study examined the results of contrast-enhanced computed tomography and venous ultrasonography of patients with primary acute PE and DVT. We assessed the association between the occurrence of right heart failure and age; gender; pulmonary thrombosis distribution; most proximal site of deep vein thrombosis in the soleal vein, inferior vena cava (IVC), or common iliac vein (CIV); DVT distribution; and malignancy using univariate and multivariate logistic regression. In all, 77 of 165 patients were male (mean age: 65.1 ± 13.7 years). Right heart failure occurred in 53 patients (32.1%). Multivariate analysis revealed that the odds ratio (OR) for right heart failure was significantly lower in patients with the most proximal site of DVT in the IVC/CIV (OR = 0.07, 95% confidence interval [CI] 0.01-0.62, A significant factor involved in PE without right heart failure was the most proximal site of DVT in the IVC/CIV, and significant risk factors associated with PE with right heart failure were more prevalent in females and in patients who exhibited the presence of bilateral venous thrombosis.
Sections du résumé
BACKGROUND
BACKGROUND
The relationship between the risk of right heart failure in primary acute pulmonary embolism after embolization and the residual thrombus sites in the pelvis and lower limbs is not clear.
METHODS
METHODS
This single-center retrospective observational study examined the results of contrast-enhanced computed tomography and venous ultrasonography of patients with primary acute PE and DVT. We assessed the association between the occurrence of right heart failure and age; gender; pulmonary thrombosis distribution; most proximal site of deep vein thrombosis in the soleal vein, inferior vena cava (IVC), or common iliac vein (CIV); DVT distribution; and malignancy using univariate and multivariate logistic regression.
RESULTS
RESULTS
In all, 77 of 165 patients were male (mean age: 65.1 ± 13.7 years). Right heart failure occurred in 53 patients (32.1%). Multivariate analysis revealed that the odds ratio (OR) for right heart failure was significantly lower in patients with the most proximal site of DVT in the IVC/CIV (OR = 0.07, 95% confidence interval [CI] 0.01-0.62,
CONCLUSION
CONCLUSIONS
A significant factor involved in PE without right heart failure was the most proximal site of DVT in the IVC/CIV, and significant risk factors associated with PE with right heart failure were more prevalent in females and in patients who exhibited the presence of bilateral venous thrombosis.
Identifiants
pubmed: 32489758
doi: 10.1002/jgf2.305
pii: JGF2305
pmc: PMC7260167
doi:
Types de publication
Journal Article
Langues
eng
Pagination
63-70Informations de copyright
© 2020 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association.
Déclaration de conflit d'intérêts
The authors have stated explicitly that there are no conflict of interest in connection with this article.
Références
Chest. 2002 Mar;121(3):877-905
pubmed: 11888976
Chest. 1999 Oct;116(4):903-8
pubmed: 10531151
J Med Ultrason (2001). 2008 Mar;35(1):33-6
pubmed: 27278564
Circ J. 2011;75(5):1258-81
pubmed: 21441695
Radiology. 2006 Jul;240(1):256-62
pubmed: 16720870
J Vasc Interv Radiol. 2006 Mar;17(3):435-47; quiz 448
pubmed: 16567668
Leg Med (Tokyo). 2008 Mar;10(2):57-71
pubmed: 18037329
Ann Vasc Dis. 2016;9(1):15-21
pubmed: 27087868
Nihon Kokyuki Gakkai Zasshi. 2010 Aug;48(8):551-64
pubmed: 20803971
Radiology. 2012 Oct;265(1):283-93
pubmed: 22993221
Heart Vessels. 2015 Sep;30(5):647-56
pubmed: 24942383