Evaluating the hemodynamic impact of saddle versus non-saddle pulmonary embolism: insights from a thrombectomy cohort.

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Invasive Cardiology Pub Date : 2024-06-17 DOI:10.25270/jic/24.00156

Robert S Zhang, Eugene Yuriditsky, Eric Bailey, Lindsay Elbaum, Allison A Greco, Radu Postelnicu, Vikramjit Mukherjee, Norma Keller, Carlos L Alviar, James M Horowitz, Sripal Bangalore

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引用次数: 0

Abstract

Objectives: The aim of this study was to compare the hemodynamic impact and clinical outcomes of saddle vs non-saddle pulmonary embolism (PE).

Methods: This was a retrospective analysis of clinical characteristics and outcomes among patients with saddle and non-saddle PE within a cohort referred for catheter-based thrombectomy (CBT) with invasive hemodynamic assessments. Patients who underwent CBT between August 2020 and January 2024 were included. The primary outcome was the proportion of patients with a low cardiac index (CI < 2.2 L/min/m²). Secondary outcomes included 30-day mortality, intensive care unit (ICU) length of stay (LOS), and hospital LOS.

Results: A total of 107 patients (84 intermediate risk, 23 high-risk; mean age 58 years, 47.6% female) were included in the study, with 44 patients having saddle PE and 63 having non-saddle PE. There were no significant differences in baseline demographics and clinical characteristics between saddle and non-saddle PE, including rates of high-risk PE (25% vs 16%, P = .24), rates of RV dysfunction, pulmonary artery systolic pressure (55 vs 53 mm Hg, P = .74), mean pulmonary artery pressure (34 mm Hg vs 33 mm Hg), low cardiac index (56% vs 51%, P = .64), rates of normotensive shock (27% vs 20%, P = .44), or Composite Pulmonary Embolism Shock scores (4.5 vs 4.7, P = .25). Additionally, 30-day mortality (6% vs 5%, P = .69), ICU LOS, and hospital LOS were similar between the groups.

Conclusions: Among patients undergoing CBT, there were no significant differences in invasive hemodynamic parameters or clinical outcomes between those with saddle and non-saddle PE.

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评估鞍式与非鞍式肺栓塞对血液动力学的影响：血栓切除术队列的启示。

研究目的本研究旨在比较鞍型与非鞍型肺栓塞（PE）对血液动力学的影响和临床结果：这是对转诊接受导管血栓切除术（CBT）并进行侵入性血液动力学评估的鞍部和非鞍部肺栓塞患者的临床特征和预后进行的回顾性分析。研究纳入了 2020 年 8 月至 2024 年 1 月期间接受 CBT 的患者。主要结果是低心脏指数（CI < 2.2 L/min/m²）患者的比例。次要结果包括 30 天死亡率、重症监护室（ICU）住院时间和住院时间：共有 107 名患者（中危 84 人，高危 23 人；平均年龄 58 岁，47.6% 为女性）参与了研究，其中 44 名患者为鞍部 PE，63 名患者为非鞍部 PE。鞍式和非鞍式 PE 的基线人口统计学和临床特征无明显差异，包括高风险 PE 的发生率（25% vs 16%，P = .24）、RV 功能障碍的发生率、肺动脉收缩压（55 vs 53 mm Hg，P = .74）、肺动脉平均压（34 mm Hg vs 33 mm Hg）、低心脏指数（56% vs 51%，P = .64）、血压正常休克率（27% vs 20%，P = .44）或肺栓塞休克综合评分（4.5 vs 4.7，P = .25）。此外，两组患者的30天死亡率（6% vs 5%，P = .69）、重症监护室住院时间和住院时间相似：结论：在接受 CBT 治疗的患者中，鞍上和非鞍上 PE 患者的有创血流动力学参数或临床结果无明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Invasive Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.90

自引率

6.70%

发文量

214

审稿时长

3-8 weeks

期刊介绍： The Journal of Invasive Cardiology will consider for publication suitable articles on topics pertaining to the invasive treatment of patients with cardiovascular disease.