In this prospective study of 386 normotensive patients with acute PE, researchers evaluated the prognostic value of RV strain (EKG with S1Q3T3, t-wave inversions V1-V4, or incomplete RBBB) and RV dysfunction (end diastolic diameter >30mm or right/left end diastolic diameter>1 ) on outcome (in-hospital clinical deterioration or death). They found RV strain independently predicted the outcome (HR 2.6), and that the combination of RV strain and RV dysfunction independently predicted the outcome (HR 8.5). Also of note, the absence of these factors had high negative predictive values (97% for absence of RV strain and 98% for absence of RV dysfunction), which can be used to determine those at LOW risk for adverse outcomes (abstract)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.