Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate

Am Heart J. 1997 Sep;134(3):479-87. doi: 10.1016/s0002-8703(97)70085-1.


To test the hypothesis that right ventricular (RV) systolic dysfunction at the time of diagnosis of pulmonary embolism (PE) is a predictor of mortality rate, 126 consecutive patients with PE were examined with echocardiography Doppler (ED) on the day of diagnosis. RV function was assessed by evaluation of wall motion on a four-point scale. The material was divided into two groups: group A (n = 56) with normal or slightly reduced RV function and group B (n = 70) with moderately or severely reduced RV function. The overall mortality rate was 7.9% in the hospital and 15.1% within 1 year. Four deaths occurred in group A and 15 in group B (p = 0.04). All in-hospital deaths (n = 10) occurred in group B (p = 0.002). The variables associated with mortality rate were RV dysfunction and cancer (in-hospital, p = 0.002 and 0.004; 1 year, p = 0.04 and < 0.001, respectively). Nine (7.1%) deaths (all in-hospital) were caused by PE. Five of these patients had advanced-stage cancer. The in-hospital mortality rate in patients without cancer was 4%, all from PE and all in group B. In conclusion, RV dysfunction when diagnosis of PE is established is associated with mortality rate. A strategy for risk stratification of patients with PE with ED may be of clinical usefulness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cause of Death
  • Echocardiography, Doppler*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / mortality*
  • Pulmonary Embolism / physiopathology*
  • Ventricular Dysfunction, Right*