Combined Echocardiographic and Laboratory Indices as Predictors of In-hospital outcome of Acute Pulmonary Embolism

Background: Progression of normotensive patients with APE to hemodynamic instability is thought to be associated with Mechanical and Inflammatory changes. Objective: to establish the ability of some new Echocardiographic and Inflammatory indices to predict the outcome of normotensive APE patients in an In-hospital setting. Patients and Methods: This prospective cohort study included 62 normotensive patients diagnosed as acute pulmonary embolism by CTPA. Six parameters were recorded for these patients (LVOT-VTI- RV/LV basal diameter ratio- RAVI- PLR- NLR- Troponin) and all patients were followed up during hospital stay for development of adverse events. According to outcome they were divided in two groups, and the indices were compared in both groups. Results: Echocardiographic parameters including RV/LV ratio, LVOT VTI and RAVI as well as laboratory parameters including NLR, PLR and Troponin to predict PE-related adverse events, including mortality, cardiac arrest, hemodynamic instability, and need of rescue thrombolysis during hospitalization were directly compared in 62 normotensive patients with acute PE. Conclusion: LVOT VTI, RV/LV basal diameter ratio, RAVI, NLR, PLR and troponin are all useful tools independently or combined to identify normotensive patients with APE who are at risk of developing in-hospital poor outcome.