Right ventricular longitudinal strain in patients with pulmonary embolism

Mazur E.S., Mazur V.V., Rabinovich R.M., Myasnikov K.S., Orlov Yu.A.

Purpose. To compare the right ventricular longitudinal strain values in patients with pulmonary embolism according to different early mortality risk.

Material and Methods. 63 patients with pulmonary embolism were including in this study: the early mortality risk was rated as high in 15 patients, as intermediate-risk – in 36 patients, and as low early mortality risk – in 12 patients.  The right ventricular systolic function was analyzed with speckle tracking global longitudinal strain, also the right ventricular free-wall longitudinal strain and the ventricular septum strain were measured, the ratio of right ventricular free-wall longitudinal strain to longitudinal strain of the ventricular septum strain was calculated. Absolute strain values were used for statistical processing and data presentations.

Results. The right ventricular global longitudinal strain was lower of normal range (<20 %) in 10 (83,3 %) patients with low early mortality risk pulmonary embolism, in 31 (86,1 %) patients with intermediate-risk pulmonary embolism and in all patients with high-risk pulmonary embolism (p >0,05). Average value of the right ventricular global longitudinal strain in patients with low early mortality risk pulmonary embolism (18,1 %) was higher than in patients with intermediate-risk pulmonary embolism (15,9 %, p <0,05), and average value of the right ventricular global longitudinal strain in patients with intermediate-risk pulmonary embolism was higher than in patients with high-risk pulmonary embolism (9,73 %, p <0,05). The ratio of right ventricular free-wall longitudinal strain to longitudinal strain of the ventricular septum strain in patients with low early mortality risk pulmonary embolism was almost 1, in patients with intermediate-risk pulmonary embolism – decreased to 0,84, and in patients with high-risk pulmonary embolism –  decreased to 0,68 (both p <0,05).

Conclusion. There is a decrease of global right ventricular longitudinal strain and the ratio of right ventricular free-wall longitudinal strain to longitudinal strain of the ventricular septum strain. These changes appear in patients with low early mortality risk pulmonary embolism, increase in patients with intermediate-risk pulmonary embolism and reach a maximum in patients with high-risk pulmonary embolism.

1 - Tver State Medical University, Sovetskaya.

2 - Tver Regional Hospital.

Tver, Russia.

2 - Rostov State Medical University of Ministry of Healthcare of Russian Federation.

Rostov-on-Don, Russia.

3 - Kuban State Medical University of Ministry of Healthcare of Russian Federation.

Krasnodar, Russia.

4 - Samara State Medical University of Ministry of Healthcare of Russian Federation.

Samara, Russia.

 

Keywords: pulmonary embolism, right ventricular longitudinal strain, pulmonary embolism related early mortality risk.

 

Corresponding author:  Mazur E.S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Mazur E.S., Mazur V.V., Rabinovich R.M., Myasnikov K.S., Orlov Yu.A. Right ventricular longitudinal strain in patients with pulmonary embolism. REJR 2020; 10(1):65-73. DOI:10.21569/2222-7415-2020-10-1-65-73.

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Received:       30.10.19 Accepted:     18.02.20