Right atrial and ventricular function evaluated with speckle tracking in patients with acute pulmonary embolism

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• 作者：Emilie Ramberg ; MD ; ^{eram12@live.dk} ; Maria Olausson ; Tem Bendix Salkvist Jø ; rgensen ; MD ; Malene Lindholmer Nepper ; Priya Bhardwaj ; Tomas Sorm Binko ; MD ; Jan Roland Petersen ; Gitte Gleerup Fornitz ; MD ; PhD
• 刊名：The American Journal of Emergency Medicine
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：35
• 期：1
• 页码：136-143
• 全文大小：991 K
• 卷排序：35

文摘

Assessment of right ventricular (RV) function in acute pulmonary embolism (PE) has prognostic significance. The aim of this study was to evaluate right atrium (RA) and RV myocardial damage with 2-dimensional speckle-tracking in patients with an acute central vs an acute peripheral PE.Methods and ResultsTwenty-six patients with acute PE and 10 controls were retrospectively enrolled. Right atrium and RV myocardial deformation was analyzed using speckle-tracking imaging echocardiography. Parameters were evaluated to illustrate myocardial damage in patients with a central or a peripherally located PE.Thirteen of the enrolled patients had a massive central PE, and thirteen subjects had a peripheral located PE. Baseline characteristics were not significantly different between the 3 groups besides a more elevated heart rate among patients with a central PE (P = .02) and a tendency of an increased D-dimer in this group. Right ventricular dimensions were more affected among patients with a PE. Compared with controls, segmental RV and RA strain/strain rate in the free wall was significantly reduced in patients with PE (P < .05). No difference was shown between the 2 groups of PE.ConclusionThis pilot study suggests that basal-/mid-segments of RA and RV free wall are more affected in patients with a PE compared with controls. Interestingly, we found no significant difference in myocardial RA and RV damage between patients with a central and a peripheral PE. We advocate that PE no matter central or peripheral is a serious condition and that a peripheral PE has to be intensively treated similar to a central PE.