Ballas Christos, Sfairopoulos Dimitrios, Samara Ioanna, Lakkas Lampros, Kardakari Olga, Konstantinidis Athanasios, Naka Katerina K, Michalis Lampros K, Katsouras Christos S
Department of Cardiac Surgery, University Hospital of Ioannina, 455 00 Ioannina, Greece.
First Department of Cardiology, University Hospital of Ioannina, 455 00 Ioannina, Greece.
J Cardiovasc Dev Dis. 2024 Dec 31;12(1):15. doi: 10.3390/jcdd12010015.
(1) Background: There are little data about the differences in clinical and echocardiographic characteristics between elderly (aged ≥ 65 years) and younger patients with acute pulmonary embolism (PE). (2) Methods: Consecutive patients diagnosed with PE in a tertiary hospital were identified. Clinical characteristics, biomarkers and transthoracic echocardiography indices including right ventricular free wall longitudinal strain (RV-FWLS) were recorded. (3) Results: Of 200 patients enrolled, 19 patients had high-risk PE and were excluded from the study. Compared to younger patients, elderly patients with PE had less frequently pain and typical symptoms and more often were hospitalized due to another reason before the PE diagnosis. The elderly had higher values of D-dimer, high-sensitivity troponin I and brain natriuretic peptide (BNP). Echocardiographic differences were noted and the elderly had lower values of pulmonary vascular acceleration time, RV E/A ratio and lower tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio. The RV-FWLS index did not show a statistically significant difference in distribution between age groups ≥ 65 and <65 years old. The RV diameter was similar across all age groups. (4) Conclusions: The elderly have differences compared with younger patients with PE regarding the mode of presentation, the values of biomarkers like D-dimer, BNP and troponins and some echocardiographic indices of RV affection.
(1) 背景：关于老年（年龄≥65岁）和年轻急性肺栓塞（PE）患者临床及超声心动图特征差异的数据较少。(2) 方法：确定一家三级医院中连续诊断为PE的患者。记录临床特征、生物标志物及经胸超声心动图指标，包括右心室游离壁纵向应变（RV-FWLS）。(3) 结果：在纳入的200例患者中，19例有高危PE，被排除在研究之外。与年轻患者相比，老年PE患者疼痛及典型症状出现频率较低，且在PE诊断前因其他原因住院的情况更为常见。老年患者D-二聚体、高敏肌钙蛋白I和脑钠肽（BNP）值更高。观察到超声心动图差异，老年患者肺血管加速时间、RV E/A比值及三尖瓣环平面收缩期位移/肺动脉收缩压比值更低。RV-FWLS指数在≥65岁和<65岁年龄组之间的分布未显示出统计学显著差异。各年龄组的RV直径相似。(4) 结论：与年轻PE患者相比，老年患者在表现形式、D-二聚体、BNP和肌钙蛋白等生物标志物值以及RV受累的一些超声心动图指标方面存在差异。
