Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study

Yıl: 2022 Cilt: 30 Sayı: 3 Sayfa Aralığı: 17 - 26 Metin Dili: İngilizce DOI: 10.5606/tgkdc.dergisi.2022.22798 İndeks Tarihi: 21-05-2023

Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study

Öz:
Background:­We aimed to determine the clinical, echocardiographic and hemodynamic correlates of syncope as a presenting symptom in pulmonary embolism and its impact on in-hospital and long-term outcomes. Methods: Between July 2012 and October 2019, a total of 641 patients with PE (277 males, 364 females; median age: 65 years; range, 51 to 74 years) in whom the diagnostic work-up and risk-based management were performed according to the current pulmonary embolism guidelines were retrospectively analyzed. Clinical, laboratory and imaging data of the patients were obtained from hospital database system. Results:­ Syncope was noted in 193 (30.2%) of patients on admission, and was associated with a significantly higher-risk status manifested by elevated troponin and D-dimer levels, a higher Pulmonary Embolism Severity Index scores, deterioration of right-to-left ventricular diameter ratio, right ventricular longitudinal contraction measures, the higher Qanadli score, and higher rates of thrombolytic therapies (p<0.001) and rheolytic– thrombectomy (p= 0.037) therapies. In-hospital mortality (p= 0.007) and minor bleeding (p<0.001) were significantly higher in syncope subgroup. Multivariate logistic regression analysis showed that higher Pulmonary Embolism Severity Index scores and right-to-left ventricular diameter ratio were independently associated with syncope, while aging and increased heart rate predicted in-hospital mortality. Malignancy and right-to-left ventricular diameter ratio at discharge, but not syncope, were independent predictors of cumulative mortality during follow-up. Conclusion:­Syncope as the presenting symptom is associated with a higher risk due to more severe obstructive pressure load and right ventricular dysfunction requiring more proactive strategies in patients with pulmonary embolism. However, with appropriate risk-based therapies, neither in-hospital mortality nor long-term mortality can be predicted by syncope.
Anahtar Kelime: Acute pulmonary embolism mortality risk prediction syncope.

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA keskin b, Tokgoz H, Akbal O, Hakgor A, Karagoz A, Kültürsay B, Tanyeri S, Külahçıoğlu Ş, Tanboga I, ÖZDEMİR N, Kaymaz C (2022). Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. , 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
Chicago keskin berhan,Tokgoz Hacer Ceren,Akbal Ozgur Yasar,Hakgor Aykun,Karagoz Ali,Kültürsay Barkın,Tanyeri Seda,Külahçıoğlu Şeyhmus,Tanboga Ibrahim Halil,ÖZDEMİR NİHAL,Kaymaz Cihangir Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. (2022): 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
MLA keskin berhan,Tokgoz Hacer Ceren,Akbal Ozgur Yasar,Hakgor Aykun,Karagoz Ali,Kültürsay Barkın,Tanyeri Seda,Külahçıoğlu Şeyhmus,Tanboga Ibrahim Halil,ÖZDEMİR NİHAL,Kaymaz Cihangir Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. , 2022, ss.17 - 26. 10.5606/tgkdc.dergisi.2022.22798
AMA keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. . 2022; 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
Vancouver keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. . 2022; 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
IEEE keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C "Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study." , ss.17 - 26, 2022. 10.5606/tgkdc.dergisi.2022.22798
ISNAD keskin, berhan vd. "Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study". (2022), 17-26. https://doi.org/10.5606/tgkdc.dergisi.2022.22798
APA keskin b, Tokgoz H, Akbal O, Hakgor A, Karagoz A, Kültürsay B, Tanyeri S, Külahçıoğlu Ş, Tanboga I, ÖZDEMİR N, Kaymaz C (2022). Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 30(3), 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
Chicago keskin berhan,Tokgoz Hacer Ceren,Akbal Ozgur Yasar,Hakgor Aykun,Karagoz Ali,Kültürsay Barkın,Tanyeri Seda,Külahçıoğlu Şeyhmus,Tanboga Ibrahim Halil,ÖZDEMİR NİHAL,Kaymaz Cihangir Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. Türk Göğüs Kalp Damar Cerrahisi Dergisi 30, no.3 (2022): 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
MLA keskin berhan,Tokgoz Hacer Ceren,Akbal Ozgur Yasar,Hakgor Aykun,Karagoz Ali,Kültürsay Barkın,Tanyeri Seda,Külahçıoğlu Şeyhmus,Tanboga Ibrahim Halil,ÖZDEMİR NİHAL,Kaymaz Cihangir Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.30, no.3, 2022, ss.17 - 26. 10.5606/tgkdc.dergisi.2022.22798
AMA keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2022; 30(3): 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
Vancouver keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2022; 30(3): 17 - 26. 10.5606/tgkdc.dergisi.2022.22798
IEEE keskin b,Tokgoz H,Akbal O,Hakgor A,Karagoz A,Kültürsay B,Tanyeri S,Külahçıoğlu Ş,Tanboga I,ÖZDEMİR N,Kaymaz C "Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 30, ss.17 - 26, 2022. 10.5606/tgkdc.dergisi.2022.22798
ISNAD keskin, berhan vd. "Clinical, imaging and hemodynamic correlates and prognostic impact of syncope in acute pulmonary embolism: A single-center study". Türk Göğüs Kalp Damar Cerrahisi Dergisi 30/3 (2022), 17-26. https://doi.org/10.5606/tgkdc.dergisi.2022.22798