Moady Gassan, Mobarki Loai, Or Tsafrir, Shturman Alexander, Atar Shaul
Department of Cardiology, Galilee Medical Center, Nahariya 2210001, Israel.
Azrieli Faculty of Medicine, Bar Ilan University, Safed 2210001, Israel.
J Clin Med. 2025 Apr 14;14(8):2685. doi: 10.3390/jcm14082685.
: The pulmonary artery pulsatility index (PAPI) is a novel hemodynamic parameter that reflects right ventricular (RV) function. PAPI was shown to be useful in predicting outcomes following left ventricular assist device (LVAD) implantation, acute RV infarction, and in patients with chronic RV failure. The standard method to estimate PAPI is during right heart catheterization (RHC); however, echocardiography-based PAPI was also shown to be accurate. In the current study, we evaluated the ability of echocardiography-based PAPI to predict outcomes of patients with acute pulmonary embolism (PE). : A total of 177 patients (mean age 67 ± 15, 54.1% male) with acute PE were included in the study. PAPI was calculated based on measurements from standard transthoracic echocardiography. : 27% of patients needed oxygen support, 5.6% were on mechanical ventilation, and 7.3% were on inotropic support. The 30-day mortality rate in the whole cohort was 8.3%. Lower PAPI measurements were associated with increased 30-day mortality ( < 0.05), a higher rate of RV failure ( < 0.001), and the need for inotropic support ( < 0.05). There was no association between PAPI and the need for oxygen support ( = 0.59), mechanical ventilation (0.06), or length of stay (LOS) ( = 0.414). PAPI was superior to tricuspid annular plane systolic excursion (TAPSE) in predicting mortality and RV failure. Echocardiography-derived PAPI is feasible and superior over TAPSE in predicting RV failure and mortality among patients with acute PE.
肺动脉搏动指数（PAPI）是一种反映右心室（RV）功能的新型血流动力学参数。PAPI已被证明在预测左心室辅助装置（LVAD）植入、急性右心室梗死以及慢性右心室衰竭患者的预后方面是有用的。估计PAPI的标准方法是在右心导管检查（RHC）期间；然而，基于超声心动图的PAPI也被证明是准确的。在本研究中，我们评估了基于超声心动图的PAPI预测急性肺栓塞（PE）患者预后的能力。
共有177例急性PE患者（平均年龄67±15岁，男性占54.1%）纳入研究。PAPI是根据标准经胸超声心动图测量值计算得出的。
27%的患者需要氧气支持，5.6%的患者接受机械通气，7.3%的患者接受强心支持。整个队列的30天死亡率为8.3%。较低的PAPI测量值与30天死亡率增加（<0.05）、右心室衰竭发生率较高（<0.001）以及需要强心支持（<0.05）相关。PAPI与需要氧气支持（=0.59）、机械通气（0.06）或住院时间（LOS）（=0.414）之间无关联。在预测死亡率和右心室衰竭方面，PAPI优于三尖瓣环平面收缩期位移（TAPSE）。
超声心动图得出的PAPI在预测急性PE患者的右心室衰竭和死亡率方面是可行的，且优于TAPSE。
