Effects of elevated pulmonary artery pressure measured by echocardiography on clinical characteristics and adverse events in patients with acute pulmonary embolism / 中华急诊医学杂志

ABSTRACT

Objective:To analyze the effect of elevated pulmonary artery pressure measured by echocardiography on clinical characteristics and adverse events in patients with acute pulmonary embolism.Methods:Retrospective analysis hospitalized patients with acute pulmonary embolism diagnosed in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 1, 2018 to December 31, 2020 were divided into elevated pulmonary artery pressure group and control group according to pulmonary artery pressure measured by echocardiography. The differences between the two groups in admission baseline data, admission basic situation, admission hematology examination, admission imaging examination, in-hospital medication and in-hospital adverse events were compared.Results:A total of 568 patients with acute pulmonary embolism were included, including 178 in the elevated pulmonary artery pressure group and 390 in the control group. The data analysis of the two groups showed that the proportion of height, weight, body mass index, smoking history, coronary heart disease history, stroke history, diabetes history, chronic heart failure history, chronic obstructive pulmonary disease history and chronic renal insufficiency history in the group with elevated pulmonary artery pressure was significantly higher than that in the control group. The proportion of fracture in the group with elevated pulmonary artery pressure was significantly lower than that in the control group, and the proportion of tumor and heart rate were significantly higher than those in the control group. The hemoglobin, international standardized ratio, D-dimer, PaO 2, SaO 2, etc. of patients with elevated pulmonary artery pressure were significantly lower than those of the control group, and TnI, B-type natriuretic peptide, etc. were significantly higher than those of the control group. The left ventricular ejection fraction of patients with elevated pulmonary artery pressure was significantly lower than those of the control group, and the left ventricular end diastolic diameter, the proportion of mitral regurgitation, the proportion of tricuspid regurgitation, and the proportion of pulmonary artery embolism were significantly higher than those of the control group. The use proportion of rivaroxaban in patients with elevated pulmonary artery pressure was significantly lower than that in the control group, and the use proportion of aspirin and warfarin was significantly higher than that in the control group. The incidence of all-cause death, acute heart failure and in-hospital hemorrhage in the group with elevated pulmonary artery pressure was significantly higher than that in the control group. There was no significant difference in other indexes between the two groups. Conclusions:There are some differences in clinical characteristics and prognosis between patients with acute pulmonary embolism complicated with elevated pulmonary artery pressure and patients with normal pulmonary artery pressure. The increase of pulmonary artery pressure may increase the risk of all-cause death, acute heart failure and nosocomial bleeding to a certain extent.