Comparison of areas under the curve (AUC) was done with the method suggested by Hanley and McNeil.15) Time to first event analysis was performed using a Cox proportional hazards model with the combined endpoint of death, recurrence of PE and PE related hospital admission. To avoid overfitting of the model, we used a bootstrapping in that analysis. A p value less than 0.05 was considered statistically significant. Results Patient characteristics A total 50 consecutive patients (38 females, mean age 68 ± 14 years old) were included in this

study. Their baseline clinical and routine echocardiographic data are listed in Table 1. Common underlying Inhibitors,research,lifescience,medical etiologies were operations, malignancies and cerebrovascular accidents. In our study cohort, 9 had surgical treatments within 1 month. Five of them had orthopedic surgery of their lower extremities, 2 had abdominal surgeries, 1 had spinal surgery and 1 had flap surgery of her buttock. Six had malignancy; Inhibitors,research,lifescience,medical 2 stomach cancer, 1 pancreatic cancer, 1 renal cell carcinoma, 1 colon cancer and 1 bladder cancer. However, the underlying cause was not identified in about 42% of the patients. RV systolic dysfunction, defined by RVFAC less than 35%, was present in 39 patients (78%) and 17 patients (34%) underwent thrombolytic therapy. Of them, 2 had complications Inhibitors,research,lifescience,medical associated with thrombolytic therapy (1 minor bleeding and 1 major bleeding).

Table 1 Baseline characteristics (n = 50) Echocardiographic findings McConnell’s sign was found in 33 patients (66%). TAPSE and TASV showed significant correlation (r = 0.582, p < 0.001). TAPSE showed significant correlations with RVFAC (r Inhibitors,research,lifescience,medical = 0.841, p < 0.001), RV Tei index (r = -0.347, p = 0.018), pulmonary vascular resistance (PVR) (r = -0.635, p < 0.001) and LogBNP (r = -0.634, p < 0.001) (Fig. 1). TASV showed significant correlations with RVFAC (r = 0.605, p < 0.001), RV Tei index (r = -0.380, p = 0.009), PVR (r = -0.483, p = 0.001) and LogBNP (r = -0.477, p = 0.001) (Fig. 2). TAPSE showed

significant correlations with serum markers of RV dysfunction such as troponin-I level (r = -0.335, p = Inhibitors,research,lifescience,medical 0.019) and creatinine kinase-MB (CK-MB, r = -0.402, p = 0.005). However, TASV did not reveal the correlation with troponin I and CK-MB. Fig. 1 Correlations between tricuspid annular plane systolic excursion (TAPSE) and echocardiographic parameters and serum old B-natriuretic 5 FU peptide (BNP) level. TAPSE shows good correlations with RV fractional area change (RVFAC, A), RV Tei index (B), pulmonary … Fig. 2 Correlations between tricuspid annular systolic velocity (TASV) and echocardiographic parameters and serum B-natriuretic peptide (BNP) level. TASV shows good correlations with RV fractional area change (RVFAC, A), RV Tei index (B), pulmonary vascular … Echocardiographic parameters were improved with treatment during hospitalization (mean duration: 5.1 ± 6.3 days).