• David Jiménez, Carlos Escobar, David Martí, Gema Díaz, Rafael Vidal, Dolores Taboada, Javier Ortega, José Luis Moya, Vicencio Barrios, and Antonio Sueiro.
• Servicio de Neumología, Hospital Ramón y Cajal, Madrid, España. djc_69_98@yahoo.com
• Arch. Bronconeumol. 2007 Sep 1;43(9):490-4.

ObjectiveTo determine the prognostic value of transthoracic echocardiography in hemodynamically stable patients diagnosed with acute symptomatic pulmonary embolism.Patients And MethodsHemodynamically stable outpatients diagnosed with acute symptomatic pulmonary embolism at a tertiary university hospital were prospectively included in the study. All patients underwent transthoracic echocardiography within 48 hours of diagnosis. The primary endpoint was all-cause mortality at 1 month.ResultsRight ventricular dysfunction was documented by echocardiography in 86 of the 214 patients (40%) in our series. In the first month of follow-up, 7 patients died--4 with positive echocardiographic findings and 3 with negative findings (odds ratio, 2.0; 95% confidence interval, 0.4-9.3; P=.41). For the primary endpoint, the negative predictive value of transthoracic echocardiography was 98%, the positive predictive value was 5%, and the negative likelihood ratio was 0.7. The negative predictive value was 100% and the positive predictive value was 3% when we analyzed death due to pulmonary embolism only.ConclusionsIn our setting, transthoracic echocardiography is not useful for prognostic stratification of hemodynamically stable patients with pulmonary embolism.

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