PMID- 36198416
OWN - NLM
STAT- MEDLINE
DCOM- 20221007
LR  - 20221209
IS  - 1600-0617 (Electronic)
IS  - 0905-9180 (Print)
IS  - 0905-9180 (Linking)
VI  - 31
IP  - 166
DP  - 2022 Dec 31
TI  - Prognostic value of echocardiography-derived right ventricular dysfunction in 
      haemodynamically stable pulmonary embolism: a systematic review and 
      meta-analysis.
LID - 10.1183/16000617.0120-2022 [doi]
LID - 220120
AB  - BACKGROUND: We sought to determine the prognostic value of transthoracic 
      echocardiography (TTE)-derived right ventricular dysfunction (RVD) in 
      haemodynamically stable and intermediate-risk patients with acute pulmonary 
      embolism (PE), evaluate continuous RVD parameters, and assess the literature 
      quality. METHODS: We searched MEDLINE, Embase and the Cochrane Central Register 
      of Controlled Trials for studies assessing TTE-derived RVD in haemodynamically 
      stable PE that reported in-hospital adverse events within 30 days. We determined 
      pooled odds ratios (ORs) using a random-effects model, created funnel plots, 
      evaluated the Newcastle-Ottawa scale and performed Grading of Recommendations, 
      Assessment, Development and Evaluation. RESULTS: Based on 55 studies (17 090 
      patients, 37.8% RVD), RVD was associated with combined adverse events (AEs) (OR 
      3.29, 95% confidence interval (CI) 2.59-4.18), mortality (OR 2.00, CI 1.66-2.40) 
      and PE-related mortality (OR 4.01, CI 2.79-5.78). In intermediate-risk patients, 
      RVD was associated with AEs (OR 1.99, CI 1.17-3.37) and PE-related mortality (OR 
      6.16, CI 1.33-28.40), but not mortality (OR 1.63, CI 0.76-3.48). Continuous RVD 
      parameters provide a greater spectrum of risk compared to categorical RVD. We 
      identified publication bias, poor methodological quality in 34/55 studies and 
      overall low certainty of evidence. CONCLUSIONS: RVD is frequent in PE and 
      associated with adverse outcomes. However, data quality and publication bias are 
      limitations of existing evidence.
CI  - Copyright (c)The authors 2022.
FAU - Prosperi-Porta, Graeme
AU  - Prosperi-Porta G
AD  - University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
FAU - Ronksley, Paul
AU  - Ronksley P
AD  - O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
AD  - Department of Community Health Sciences, University of Calgary, Calgary, AB, 
      Canada.
FAU - Kiamanesh, Omid
AU  - Kiamanesh O
AD  - Division of Cardiology, Department of Cardiac Sciences, University of Calgary, 
      Calgary, AB, Canada.
AD  - Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, 
      Canada.
FAU - Solverson, Kevin
AU  - Solverson K
AUID- ORCID: 0000-0002-9895-8908
AD  - Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
AD  - Division of Respirology, Department of Medicine, University of Calgary, Calgary, 
      AB, Canada.
FAU - Motazedian, Pouya
AU  - Motazedian P
AD  - University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
FAU - Weatherald, Jason
AU  - Weatherald J
AUID- ORCID: 0000-0002-0615-4575
AD  - Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, 
      Canada jason.weatherald@albertahealthservices.ca.
AD  - Division of Respirology, Department of Medicine, University of Calgary, Calgary, 
      AB, Canada.
AD  - Division of Pulmonary Medicine, Department of Medicine, University of Alberta, 
      Edmonton, AB, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221005
PL  - England
TA  - Eur Respir Rev
JT  - European respiratory review : an official journal of the European Respiratory 
      Society
JID - 9111391
SB  - IM
MH  - Acute Disease
MH  - Echocardiography
MH  - Humans
MH  - Prognosis
MH  - *Pulmonary Embolism/complications
MH  - *Ventricular Dysfunction, Right/diagnostic imaging/etiology
PMC - PMC9724799
COIS- Conflicts of interest: J. Weatherald reports grants or contracts from Janssen, 
      Actelion, Bayer, Canadian Institutes for Health Research and Heart & Stroke 
      Foundation of Canada; consulting fees from Janssen and Actelion; honoraria from 
      Janssen; payment for expert testimony from Spigings Intellectual Property Law; 
      travel support from Janssen; and participation on a Data Safety Monitoring Board 
      or Advisory Board for Janssen, Acceleron and Universite Laval. J. Weatherald is a 
      member of the Medical Advisory Committee of the Pulmonary Hypertension 
      Association of Canada. He is a shareholder in a pulmonary function testing 
      laboratory (Precision Lung Consultants and Diagnostics). All other authors have 
      no conflicts to declare.
EDAT- 2022/10/06 06:00
MHDA- 2022/10/12 06:00
PMCR- 2022/10/05
CRDT- 2022/10/05 20:43
PHST- 2022/06/29 00:00 [received]
PHST- 2022/08/01 00:00 [accepted]
PHST- 2022/10/05 20:43 [entrez]
PHST- 2022/10/06 06:00 [pubmed]
PHST- 2022/10/12 06:00 [medline]
PHST- 2022/10/05 00:00 [pmc-release]
AID - 31/166/220120 [pii]
AID - ERR-0120-2022 [pii]
AID - 10.1183/16000617.0120-2022 [doi]
PST - epublish
SO  - Eur Respir Rev. 2022 Oct 5;31(166):220120. doi: 10.1183/16000617.0120-2022. Print 
      2022 Dec 31.