A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index

Ates H., Ates I., Kundi H., Arikan M. F. , Yilmaz F. M.

American Journal of Emergency Medicine, vol.35, no.10, pp.1400-1403, 2017 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 35 Issue: 10
  • Publication Date: 2017
  • Doi Number: 10.1016/j.ajem.2017.04.019
  • Journal Name: American Journal of Emergency Medicine
  • Journal Indexes: Science Citation Index Expanded, Scopus
  • Page Numbers: pp.1400-1403
  • Keywords: Blood pressure index, Diastolic blood pressure, Pulmonary thromboembolism, Ventriculary dysfunction


© 2017 Elsevier Inc.Background This study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE). Methods A total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP). Results Mean DBP (75 ± 11 mm Hg vs 63 ± 15 mm Hg; p < 0.001, respectively) was found to be higher in RVD patients compared to those without RVD, whereas BPI (1.5 ± 0.1 vs 1.9 ± 0.2; p < 0.001, respectively) was lower. Examining the performance of BPI in prediction of RVD using receiver operating characteristic curve analysis (area under curve ± SE = 0.975 ± 0.006; p < 0.001), it was found that BPI could predict RVD with very high sensitivity (92.8%) and specificity (100%) and had a positive predictive value of 100% and a negative predictive value of 42.1%. According to the analysis, the highest youden index for the optimal prediction value was found to be 0.478 and the BPI ≤ 1.4 was found to predict mortality 68.6% sensitivity and 80.8% specificity (Area under curve ± SE = 0.777 ± 0.051; p < 0.001). Conclusions We found that BPI was an index with high positive predictive value and low negative predictive value in detection of RVD.