Right heart thrombus in acute pulmonary embolism: A single center experience in China

Abstract

Abstract Right heart thrombus (RHT) is a rare but life‐threatening condition in acute pulmonary embolism (APE) without clear management guidelines. This study aimed to address the clinical characteristics and outcomes of RHT‐APE in Chinese patients. In this study, 17 RHT‐APE and 329 non‐RHT‐APE patients, who were diagnosed between September 2015 and August 2019, were retrospectively recruited with the median follow‐up was 360 days. The overall prevalence of RHT was 4.91% in APE. Its prevalence increased along the increase of APE risk stratifications. Comparisons showed that with higher proportion of male gender and younger age, RHT‐APE patients also had worse hemodynamic instability and heart function, and higher risk stratification levels than non‐RHT‐APE patients. After adjusting by age and gender, multivariate logistic regression analysis found high/intermediate‐high risk stratification, decreased right ventricular (RV) motion, NT‐proBNP >600 pg/mL, and RV dysfunction were risk factors for RHT. Kaplan−Meier analysis showed non‐RHT had better prognosis than RHT patients (30‐day survival: log‐rank: p 600 pg/mL, RV dysfunction, or high level of risk stratification, to exclude the coexistence of RHT.

Keywords

• acute pulmonary embolism
• prevalence
• prognosis
• right heart thrombus