Relationship Between the Echocardiographic Simple Right Ventricular Contraction Pressure Index and Hospital Mortality in Patients with Acute Pulmonary Embolism Undergoing Thrombolytic Therapy

Abstract

Aim: Acute pulmonary embolism (APE) remains a leading cause of cardiovascular death, with recent trends indicating an upward shift in mortality rates adjusted for age and sex. Risk assessment models for APE currently incorporate a variety of clinical, imaging, and hemodynamic parameters. The right ventricular contraction pressure index (RVCPI), a novel echocardiographic parameter, serves as an emerging tool for evaluating right ventricular (RV) systolic performance. This study explores the association between RVCPI and in-hospital mortality among patients receiving thrombolytic therapy (TT) for APE. Material and Methods: This retrospective study evaluated 75 patients diagnosed with APE who underwent TT. After applying exclusion criteria, 40 eligible patients were included. All patients underwent transthoracic echocardiography prior to treatment, and RVCPI values were computed accordingly. Results: Higher RVCPI values were significantly associated with elevated in-hospital mortality rates (819.8±121.05 vs. 1059.17±206.84, p=0.005). Univariate logistic regression revealed that gender and RVCPI were significantly linked to mortality. Multivariate analysis confirmed that RVCPI independently predicted in-hospital mortality. Receiver operating characteristic (ROC) analysis identified a threshold of RVCPI >800, which demonstrated 100% sensitivity and 64.7% specificity, Conclusion: RVCPI appears to be a reliable, non-invasive indicator for identifying high-risk APE patients undergoing thrombolytic therapy and may enhance early risk stratification.

Keywords

• pulmonary embolism
• simple right ventricular contraction pressure index
• mortality
• echocardiography

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