AIMS: Right ventricular (RV) dysfunction is a frequent consequence of pulmonary embolism (PE) and a marker of increased risk. However, current qualitative methods assessing RV function are imprecise. We sought to determine whether RV strain analysis would have clinical utility in patients with PE compared with normal controls. METHODS AND RESULTS: We compared 75 acute PE subjects (mean age 54 ± 16) with 30 normal controls (mean age 50 ± 15). Regional RV longitudinal strain was assessed using offline speckle tracking software to obtain strain and strain rate data from the basal, mid, and apical free wall and septum. Global RV free wall and septal strain was significantly reduced in PE subjects (-14.17 (±5.96) vs -24.92 (±4.16), P < 0.0001; -14.99 (±5.55) vs -18.54 (±7.34), P = 0.0082). Regional RV strain was markedly reduced in PE subjects in all regions of the free wall and in the mid and basal septum (P < 0.05). Strain rates of PE subjects were significantly reduced in all segments of the RV free wall (P < 0.05). In 36 PE subjects with regional RV dysfunction ("McConnell sign"), strain in the apical free wall was significantly reduced in comparison to those without (-10.08 vs -13.51; P = 0.0420), in parallel with higher RV:LV ratios (1.30, ±1.01 vs 0.78, ±0.16; P = 0.0035) and lower RV fractional area change (32.06, ±14.42 vs 42.52, ±11.61; P = 0.0021). CONCLUSIONS: Regional RV longitudinal strain is altered in the free wall and mid and basal septum in subjects with acute PE. Strain rates are only reduced in the RV free wall.
AIMS: Right ventricular (RV) dysfunction is a frequent consequence of pulmonary embolism (PE) and a marker of increased risk. However, current qualitative methods assessing RV function are imprecise. We sought to determine whether RV strain analysis would have clinical utility in patients with PE compared with normal controls. METHODS AND RESULTS: We compared 75 acute PE subjects (mean age 54 ± 16) with 30 normal controls (mean age 50 ± 15). Regional RV longitudinal strain was assessed using offline speckle tracking software to obtain strain and strain rate data from the basal, mid, and apical free wall and septum. Global RV free wall and septal strain was significantly reduced in PE subjects (-14.17 (±5.96) vs -24.92 (±4.16), P < 0.0001; -14.99 (±5.55) vs -18.54 (±7.34), P = 0.0082). Regional RV strain was markedly reduced in PE subjects in all regions of the free wall and in the mid and basal septum (P < 0.05). Strain rates of PE subjects were significantly reduced in all segments of the RV free wall (P < 0.05). In 36 PE subjects with regional RV dysfunction ("McConnell sign"), strain in the apical free wall was significantly reduced in comparison to those without (-10.08 vs -13.51; P = 0.0420), in parallel with higher RV:LV ratios (1.30, ±1.01 vs 0.78, ±0.16; P = 0.0035) and lower RV fractional area change (32.06, ±14.42 vs 42.52, ±11.61; P = 0.0021). CONCLUSIONS: Regional RV longitudinal strain is altered in the free wall and mid and basal septum in subjects with acute PE. Strain rates are only reduced in the RV free wall.
Authors: Diego Medvedofsky; Karima Addetia; Jamie Hamilton; Javier Leon Jimenez; Roberto M Lang; Victor Mor-Avi Journal: Int J Cardiovasc Imaging Date: 2015-05-07 Impact factor: 2.357
Authors: Ana Cristina Lopes Albricker; Cláudia Maria Vilas Freire; Simone Nascimento Dos Santos; Monica Luiza de Alcantara; Mohamed Hassan Saleh; Armando Luis Cantisano; José Aldo Ribeiro Teodoro; Carmen Lucia Lascasas Porto; Salomon Israel do Amaral; Orlando Carlos Gloria Veloso; Ana Cláudia Gomes Pereira Petisco; Fanilda Souto Barros; Márcio Vinícius Lins de Barros; Adriano José de Souza; Marcone Lima Sobreira; Robson Barbosa de Miranda; Domingos de Moraes; Carlos Gustavo Yuji Verrastro; Alexandre Dias Mançano; Ronaldo de Souza Leão Lima; Valdair Francisco Muglia; Cristina Sebastião Matushita; Rafael Willain Lopes; Artur Martins Novaes Coutinho; Diego Bromfman Pianta; Alair Augusto Sarmet Moreira Damas Dos Santos; Bruno de Lima Naves; Marcelo Luiz Campos Vieira; Carlos Eduardo Rochitte Journal: Arq Bras Cardiol Date: 2022-04 Impact factor: 2.000