Background: The presence of right ventricular dysfunction is associated with poor prognosis in patients with acute pulmonary thromboembolism (PTE). However, its complex shape of right ventricle (RV) made the objective assessment of RV function more difficult. We aimed to evaluate RV function with systolic distance of tricuspid annulus.
Materials and methods: March 2005 to April 2007, 30 consecutive patients with acute PTE were included in this study. After excluding four patients, five with recurrent episodes of PTE and one with permanent pacemaker, the remaining 25 patients (10 males, mean age 69.2 짹 9.9 years) were analyzed. RV fractional area change (FACRV), RV ejection fraction, RV Tei index, and tricuspid annular plane systolic excursion (TAPSE) was assessed by Vivid 7 (GE Medical Systems, Waukesha, Wisconsin) from March 2005 to April 2007. Systolic distance of tricuspid annulus (SDTA) was calculated with tracing of tricuspid annular motion during systole.
Results: FACRV was 19.5 짹 8.6%; RV Tei index was 0.89 짹 0.31; TAPSE was 1.55 짹 0.31 cm; and TR Vmax was 3.7 짹 0.5 m/sec at the time of diagnosis. SDTA was 23.34 짹 6.62 mm. After treatment, follow-up echocardiographic data were obtained from 21 patients (mean: 11.0 짹 8.2 days, duration: 4 ~ 34 days). Mean FACRV, RV Tei index, TAPSE and TR Vmax were significantly improved (P < 0.001). SDTA was also significantly improved from 23.03 짹 6.32 to 31.92 짹 4.4 mm (P < 0.001). SDTA showed significant positive correlation with FACRV (r = 0.704, P < 0.001), TAPSE (r = 0.687, P < 0.001), RV Tei index (r = -0.733, P < 0.001), and TR Vmax (r = -0.561, P < 0.001).
Conclusions: SDTA was decreased in the patients with acute PTE and improved after stabilization. Also, SDTA showed significant correlation with currently used parameters assessing RV systolic function. This value can therefore be used to assess RV systolic function in patients with acute PTE.