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TITLE:

THE PREVALENCE OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH ACUTE PULMONARY EMBOLISM AND ITS IMPACT ON PROGNOSIS: A RETROSPECTIVE COHORT STUDY

AUTHORS:

Ahmed Saati, Omer Brinji, Faiz Zagzoog, Abdulrahman Alharthi, Faisal Boker1,2, Bader Alghamdi, Jamilah Alrahimi

ABSTRACT:

Background: Heart failure, mainly systolic dysfunction, has been studied as a determining factor in the prognosis of patients with acute pulmonary embolism (PE). However, left ventricular diastolic dysfunction (LVDD) has not been well studied in this regard. Methods: A total of 516 patients were diagnosed with acute PE from January 2013 to December 2016. Both hemodynamically stable and unstable patients (i.e. massive PE) who underwent echocardiography within two months of diagnosis were included. Of these, 161 patients were finally included in the study. A comparative cross-sectional study was conducted to investigate the prevalence of LVDD in patients with acute PE and its influences on in-hospital mortality or poor clinical outcomes. Results: Of 161 patients, 35 patients died during hospitalization (mortality rate 21.7%). Among 73 patients without left ventricular diastolic dysfunction, 14 died (mortality rate 19.2%). Among 88 patients with left ventricular diastolic dysfunction, 21 died (mortality rate 23.9%). The odds ratio of mortality in these patients was 1.321 (0.617 to 2.828), with 95% confidence intervals (P = 0.473). Conclusions: In patients with acute PE, LVDD identified by echocardiography was associated with higher in-hospital mortality rates (23.9 compared with 19.2 for those without LVDD), although this effect was not statistically significant. Additional studies with a larger sample size are required to fully clarify the prognostic effects of LVDD on patients with acute PE. Keywords: pulmonary embolism, heart failure, diastolic dysfunction, prevalence, mortality.

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