Can echocardiography improve care of patients with pulmonary embolism?

Determining the contemporary utilization of early echocardiography and exploring the association between echocardiography findings and PE‐related mortality.

Gel applied to chest of patient undergoing echocardiogram, which tests function of the heart.
Gel applied to chest of patient undergoing echocardiogram, which tests function of the heart. (© stock.adobe.com)

Echocardiography is a technique that uses sound waves to produce live images of your heart. Those images are also known as cardiograms.

A new study by the Yale scientists suggests that the method is a key for clinicians to better predict outcomes for individuals with pulmonary embolisms. For example, using echocardiography for patients with acute pulmonary embolism, potentially fatal condition in which a clot impedes blood flow in pulmonary arteries, clinicians can assess structural and functional changes to the heart.

During the study, scientists analyzed data from RIETE, a large international registry of patients with the condition, from 2001 to 2017. They observed that among 35,935 patients, 15,375 (42.8%) underwent early echocardiographic assessment.

In certain factors, scientists noted, such as enlargement of the right atrium, weak contraction of the right ventricle, and presence of thrombi in the right side of the heart — were associated with increased odds of 30-day mortality from a pulmonary embolism.

First author Behnood Bikdeli of Yale’s Center for Outcomes Research and Evaluation (CORE) said, “The large size of the study underscores the importance of echocardiography in the early assessment of patients with an acute pulmonary embolism. This is an important step forward in understanding that these patients have a higher risk. The next step is to start testing more advanced strategies to determine how we can improve the outcomes of patients who present with these features.”

Scientists have presented their paper at the European Society of Cardiology annual meeting, in the Journal of the American Heart Association.