PMID- 24701212
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140404
LR  - 20211021
IS  - 1734-1922 (Print)
IS  - 1896-9151 (Electronic)
IS  - 1734-1922 (Linking)
VI  - 10
IP  - 1
DP  - 2014 Feb 24
TI  - The significance of mitral and tricuspid valve systolic lateral annular 
      velocities in the diagnosis of acute pulmonary embolism in patients with chronic 
      heart failure.
PG  - 39-46
LID - 10.5114/aoms.2014.40732 [doi]
AB  - INTRODUCTION: The diagnosis of acute pulmonary embolism (APE) in patients with 
      chronic heart failure (CHF) remains a difficult task, despite the refinement of 
      imaging techniques. The goal of this study was to assess the value of measuring 
      tricuspid and mitral valve systolic annular velocities in CHF patients with 
      suspected PE by tissue Doppler imaging (TDI). MATERIAL AND METHODS: The study 
      included 75 patients with previously diagnosed CHF, admitted due to resting 
      dyspnea, with a maximum tricuspid regurgitation pressure gradient (TRPG) of >/= 35 
      mm Hg and positive D-dimer assay. Spiral computed tomography (sCT) was performed 
      on all subjects to confirm APE. Acute pulmonary embolism was diagnosed in 35 
      patients (PE+), and excluded in 40 others (PE-). Tissue Doppler imaging was 
      performed to measure maximum systolic lateral annular velocities in the mitral 
      (SmLV) and tricuspid (SmRV) valves, as well as the SmRV/SmLV ratio. RESULTS: PE+ 
      subjects were found to have higher SmLV than PE- subjects (6.0 cm/s (2.0-13.8 
      cm/s) vs. 4.2 cm/s (1.3-9.1 cm/s), p = 0.003). SmRV/SmLV ratios were 1.05 
      (0.50-2.50) and 1.56 (0.62-4.30), respectively (p < 0.0001). Areas under ROC 
      curves for diagnosis of APE were 0.700 for SmLV and 0.789 for SmRV/SmLV. In 
      multivariate logistic regression analysis, only SmRV/SmLV was statistically 
      significant, with an odds ratio for APE of 6.26 (95% CI: 1.53-25.59; p = 0.009). 
      CONCLUSIONS: Tissue Doppler imaging of the lateral tricuspid and mitral annuli is 
      a useful clinical tool that can help identify PE in CHF patients. Those patients 
      who fulfill these criteria should be considered for further diagnostic studies to 
      confirm PE.
FAU - Gromadzinski, Leszek
AU  - Gromadzinski L
AD  - Department of Internal Medicine, Gastroenterology and Hepatology, University 
      Hospital, University of Warmia and Mazury, Olsztyn, Poland ; Department of 
      Internal Medicine, Cardiology and Nephrology, Hospital, Ostroda, Poland.
FAU - Targonski, Ryszard
AU  - Targonski R
AD  - Department of Internal Medicine and Cardiology, Municipal Hospital, Olsztyn, 
      Poland.
FAU - Januszko-Giergielewicz, Beata
AU  - Januszko-Giergielewicz B
AD  - Department of Internal Medicine, Gastroenterology and Hepatology, University 
      Hospital, University of Warmia and Mazury, Olsztyn, Poland ; Department of 
      Internal Medicine, Cardiology and Nephrology, Hospital, Ostroda, Poland.
FAU - Ostrowski, Philip
AU  - Ostrowski P
AD  - Department of Internal Medicine and Cardiology, Warsaw Medical University, 
      Warsaw, Poland.
FAU - Pruszczyk, Piotr
AU  - Pruszczyk P
AD  - Department of Internal Medicine and Cardiology, Warsaw Medical University, 
      Warsaw, Poland.
LA  - eng
PT  - Journal Article
DEP - 20140223
PL  - Poland
TA  - Arch Med Sci
JT  - Archives of medical science : AMS
JID - 101258257
PMC - PMC3953976
OTO - NOTNLM
OT  - chronic heart failure
OT  - pulmonary embolism
OT  - tissue Doppler imaging
EDAT- 2014/04/05 06:00
MHDA- 2014/04/05 06:01
PMCR- 2014/02/24
CRDT- 2014/04/05 06:00
PHST- 2012/05/17 00:00 [received]
PHST- 2012/07/10 00:00 [revised]
PHST- 2012/10/06 00:00 [accepted]
PHST- 2014/04/05 06:00 [entrez]
PHST- 2014/04/05 06:00 [pubmed]
PHST- 2014/04/05 06:01 [medline]
PHST- 2014/02/24 00:00 [pmc-release]
AID - 22285 [pii]
AID - 10.5114/aoms.2014.40732 [doi]
PST - ppublish
SO  - Arch Med Sci. 2014 Feb 24;10(1):39-46. doi: 10.5114/aoms.2014.40732. Epub 2014 
      Feb 23.