Risk stratification in acute pulmonary embolism at moderate risk

Read by Kyriakos Yiangou

Main conclusion

The ratio TAPSE/PASP (TAPSE: Tricuspid Annular Plane Systolic Excursion ; PASP: Pulmonary Systolic Artery Pressure) can predict early CV death and hemodynamic decompensation in acute pulmonary embolism (PE) of moderate risk [OR = 0.0028; 95%; CI:0.010-0.087; P< 0.0001] and is superior to TAPSE or PASP alone (P = 0.017 and and P

Type of study

Retrospective study of a single center (from 2012 till 2019) of 627 patients with acute PE of moderate risk, evaluating the value of TAPSE/PASP ratio in assessing the primary end point (CV death and hemodynamic decompensation risk within 7 days) which was observed in 135 cases.

Main message for clinical practice

TAPSE and PAPS, easily derived by echocardiography, reflect systolic dysfunction of the right ventricle and its increased afterload. A TAPSE/PAPS ratio is < 0.4 a good predictor of early adverse events in patients with acute PE at moderate risk and may help in stratifying their risk and guiding their management

References

Lyhne MD et al. The echocardiographic ratio tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure predicts short-term adverse outcomes in acute pulmonary embolism. Eur Heart J Cadiovasc Imaging 2021; 22(3): 285-294