Authors:	Mavromanoli, Anna C. Barco, Stefano Ageno, Walter Bouvaist, Hélène Brodmann, Marianne Cuccia, Claudio Couturaud, Francis Dellas, Claudia Dimopoulos, Konstantinos Duerschmied, Daniel Empen, Klaus Faggiano, Pompilio Ferrari, Emile Galiè, Nazzareno Galvani, Marcello Ghuysen, Alexandre Giannakoulas, George Huisman, Menno V. Jiménez, David Kozak, Matija Lang, Irene M. Meneveau, Nicolas Münzel, Thomas Palazzini, Massimiliano Petris, Antoniu Octavian Piovaccari, Giancarlo Salvi, Aldo Schellong, Sebastian Schmid, Kai‑Helge Verschuren, Franck Schmidtmann, Irene Toenges, Gerrit Klok, Frederikus A. Konstantinides, Stavros V.
Title:	Recovery of right ventricular function after intermediate-risk pulmonary embolism : results from the multicentre Pulmonary Embolism International Trial (PEITHO)-2
Online publication date:	15-Feb-2024
Year of first publication:	2023
Language:	english
Abstract:	Background: Right ventricular (RV) function plays a critical role in the pathophysiology and acute prognosis of pulmonary embolism (PE). We analyzed the temporal changes of RV function in the cohort of a prospective multicentre study investigating if an early switch to oral anticoagulation in patients with intermediate-risk PE is effective and safe. Methods: Echocardiographic and laboratory examinations were performed at baseline (PE diagnosis), 6 days and 6 months. Echocardiographic parameters were classified into categories representing RV size, RV free wall/tricuspid annulus motion, RV pressure overload and right atrial (RA)/central venous pressure. Results: RV dysfunction based on any abnormal echocardiographic parameter was present in 84% of patients at baseline. RV dilatation was the most frequently abnormal finding (40.6%), followed by increased RA/central venous pressure (34.6%), RV pressure overload (32.1%), and reduced RV free wall/tricuspid annulus motion (20.9%). As early as day 6, RV size remained normal or improved in 260 patients (64.7%), RV free wall/tricuspid annulus motion in 301 (74.9%), RV pressure overload in 297 (73.9%), and RA/central venous pressure in 254 (63.2%). At day 180, the frequencies slightly increased. The median NT-proBNP level decreased from 1448 pg/ml at baseline to 256.5 on day 6 and 127 on day 180. Conclusion: In the majority of patients with acute intermediate-risk PE switched early to a direct oral anticoagulant, echocardiographic parameters of RV function normalised within 6 days and remained normal throughout the first 6 months. Almost one in four patients, however, continued to have evidence of RV dysfunction over the long term.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-10092
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Clinical research in cardiology 112
Pages or article number:	1372 1381
Publisher:	Springer Nature
Publisher place:	Berlin
Issue date:	2023
ISSN:	1861-0692
Publisher DOI:	10.1007/s00392-022-02138-4
Appears in collections:	DFG-491381577-H