Prognostic Value of Conventional Echocardiographic Parameters of Right Ventricular Dysfunction in a Real-World Cohort of Patients With Acute Pulmonary Embolism.
5 affiliations
- 1Cardiology, Holy Family Hospital, New Delhi, IND.
- 2Cardiology, Artemis Hospitals, New Delhi, IND.
- 3Cardiology, Max Super Speciality Hospital, New Delhi, IND.
- 4Cardiology, Max Healthcare Institute Limited, New Delhi, IND.
- 5Internal Medicine, Centerpoint Medical Center, Independence, USA.
Abstract
Background
Right ventricular (RV) dysfunction is a known marker of adverse outcomes in acute pulmonary embolism (PE). However, the prognostic utility of individual echocardiographic parameters in clinically heterogeneous patient populations remains a matter of debate. This study aimed to evaluate the association of baseline echocardiographic parameters of RV dysfunction with the Pulmonary Embolism Severity Index (PESI) score and in-hospital mortality.Methods
We prospectively enrolled 32 consecutive patients with computed tomography-confirmed acute PE. A comprehensive transthoracic echocardiogram was performed within 12 hours of admission. Parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV FAC), tricuspid annular systolic velocity (S'), and RV myocardial performance index (MPI) were measured. The PESI score was calculated for all patients. No a priori power calculation was performed, and analyses were exploratory; significance was judged against a Bonferroni-corrected threshold for the systolic parameters tested.Results
The mean age was 55.4 ± 18.0 years, and the mean PESI score was 115.2 ± 40.5, indicating a high-risk cohort (59.4% in PESI classes IV-V). In-hospital mortality was 12.5%. Baseline TAPSE, S', and RV FAC showed no significant correlation with the continuous PESI score (p = 0.084, p = 0.235, and p = 0.637, respectively) and no significant association with in-hospital mortality (p > 0.05 for all). Abnormal RV FAC (<35%) was associated with PESI class distribution (χ²(4) = 11.08, p = 0.026, Cramér's V = 0.59) but did not retain significance after correction for multiple testing.Conclusions
In this small, prospective cohort of patients with acute PE and a high burden of comorbidities, conventional echocardiographic parameters of RV systolic function, including TAPSE and S', were not significantly associated with the PESI score or in-hospital mortality, and the single positive association (RV FAC with PESI class) did not survive correction for multiple testing. Given the limited sample and few events, these exploratory findings are hypothesis-generating and are consistent with an adjunctive - rather than stand-alone - role for echocardiographic RV assessment in risk stratification.
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BibTeX
@article{bhagwati2026prognostic,
title = {{Prognostic Value of Conventional Echocardiographic Parameters of Right Ventricular Dysfunction in a Real-World Cohort of Patients With Acute Pulmonary Embolism.}},
author = {Mohit Bhagwati and Rahul Mehrotra and Amitabh Yaduvanshi and Vikas Kataria and Mohan Bhargava and Kewal Kishan Talwar and Pankti Shah and Pratyush Kumar and Kumar Abhishek},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116990},
url = {https://europepmc.org/article/MED/42948057},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prognostic Value of Conventional Echocardiographic Parameters of Right Ventricular Dysfunction in a Real-World Cohort of Patients With Acute Pulmonary Embolism.
AU - Mohit Bhagwati
AU - Rahul Mehrotra
AU - Amitabh Yaduvanshi
AU - Vikas Kataria
AU - Mohan Bhargava
AU - Kewal Kishan Talwar
AU - Pankti Shah
AU - Pratyush Kumar
AU - Kumar Abhishek
PY - 2026
DA - 2026/09/27
JO - Cureus
DO - 10.7759/cureus.116990
UR - https://europepmc.org/article/MED/42948057
AB - Background Right ventricular (RV) dysfunction is a known marker of adverse outcomes in acute pulmonary embolism (PE). However, the prognostic utility of individual echocardiographic parameters in clinically heterogeneous patient populations remains a matter of debate. This study aimed to evaluate the association of baseline echocardiographic parameters of RV dysfunction with the Pulmonary Embolism Severity Index (PESI) score and in-hospital mortality.Methods We prospectively enrolled 32 consecutive patients with computed tomography-confirmed acute PE. A comprehensive transthoracic echocardiogram was performed within 12 hours of admission. Parameters including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV FAC), tricuspid annular systolic velocity (S'), and RV myocardial performance index (MPI) were measured. The PESI score was calculated for all patients. No a priori power calculation was performed, and analyses were exploratory; significance was judged against a Bonferroni-corrected threshold for the systolic parameters tested.Results The mean age was 55.4 ± 18.0 years, and the mean PESI score was 115.2 ± 40.5, indicating a high-risk cohort (59.4% in PESI classes IV-V). In-hospital mortality was 12.5%. Baseline TAPSE, S', and RV FAC showed no significant correlation with the continuous PESI score (p = 0.084, p = 0.235, and p = 0.637, respectively) and no significant association with in-hospital mortality (p > 0.05 for all). Abnormal RV FAC (<35%) was associated with PESI class distribution (χ²(4) = 11.08, p = 0.026, Cramér's V = 0.59) but did not retain significance after correction for multiple testing.Conclusions In this small, prospective cohort of patients with acute PE and a high burden of comorbidities, conventional echocardiographic parameters of RV systolic function, including TAPSE and S', were not significantly associated with the PESI score or in-hospital mortality, and the single positive association (RV FAC with PESI class) did not survive correction for multiple testing. Given the limited sample and few events, these exploratory findings are hypothesis-generating and are consistent with an adjunctive - rather than stand-alone - role for echocardiographic RV assessment in risk stratification.
SN - 2168-8184
ER -