Background: Assessment of right ventricular (RV) systolic function remains difficult because of the RV's complex shape. We aimed to evaluate RV systolic function with two-dimensional strain (2DS) analysis in patients with acute pulmonary thromboembolism (PTE).
Materials and Methods: From March 2005 to August 2010, 56 consecutive patients with acute PTE were included in this study. After excluding 7 patients, 3 with atrial fibrillation, 3 with recurrent episodes of PTE and 1 with permanent pacemaker, the remaining 49 patients (20 males, mean age 67.2짹11.6 years) were analyzed.
Results: Mean RV fractional area change (RVFAC) was 23.7짹9.7%; RV Tei index was 0.84짹0.28; tricuspid annular plane systolic excursion (TAPSE) was 1.60짹0.35 cm; and TR Vmax was 3.7짹0.4 m/s at the time of diagnosis. Global longitudinal 2DS of RV was markedly decreased (-12.9짹6.0%). After treatment, follow-up echocardiographic data were obtained from 42 patients (mean: 9.0짹7.5 days, duration: 1–34 days). Mean RVFAC (23.7짹9.7 to 41.8짹8.0%), RV Tei index (0.84짹0.28 to 0.36짹0.36), TAPSE (1.60짹0.35 to 2.22짹0.26cm/s) and TR Vmax (3.7짹0.4 to 2.7짹0.4m/s) were significantly improved (P<0.001). Global longitudinal 2DS of RV were also significantly improved (-12.3짹0.6 to -20.8짹4.8%, P<0.001). Global longitudinal 2DS of RV showed significant correlation with RVFAC (r=−0.584, P<0.001), TAPSE (r=−0.606, P<0.001) and RV Tei index (r=0.538, P<0.001).
Conclusions: Global longitudinal 2DS of RV decreased in the patients with acute PTE and improved after stabilization. Because global longitudinal 2DS of RV showed significant correlations with conventional RV systolic parameters, it can therefore be used to assess RV systolic function in patients with acute PTE.