V.I. Tseluyko, S.M. Sukhova, K.Yu. Kinoshenko, L.M. Yakovleva Usage of 2D speckle tracking echocardiography in the diagnosis of right ventricular dysfunction in patients with acute pulmonary embolism

The aim – to study the diagnostic value of 2D speckle tracking echocardiography (2D STE) to assess functional condition of the right ventricle (RV) in patients with acute pulmonary embolism (PE).

Material and methods. One hundred and four patients were examined, average age was 62.9±13.5 years, consecutively hospitalized with acute PE determined according to ESC 2014 recommendations. All patients were examined by transthoracic echocardiography and multislice computed tomography pulmonary angiography (CTPA).

Results. Examined patients with PE were divided into two groups depending on presence of at least one echo sign of RV dysfunction: group I included 75 (72.2 %) patients with RV dysfunction; group II included 29 (27.8 %) patients without RV dysfunction. According to the 2D STE, reduction of the longitudinal strain was detected in all studied segments of group I and in four out of six segments of the group II compared to the control group. The degree of the global longitudinal strain of RV free wall was the worst in group I (5.1±7.9 % vs 23.2±7.1 % in the control group and 10.0±8.9 % in group II). The indicators of the radial velocity in basal and middle segments in patients with RV dysfunction were significantly higher in group I than in the control group (Р<0.001). Contrary, in the middle and apical RV segments these indicators were significantly lower in group I than in the control group (P<0.001). Segmental ejection fraction (SEF) of all RV segments was significantly lower in group I (Р<0.001). The descent of the SEF was recorded only in the apical and middle RV segments in group II compared to the control group (Р<0.001). Conclusions. RV dysfunction signs are not evident in patients with acute PE examined by standard echocardiography. Nevertheless, changes of right ventricular contractility in these patients may bedetected by 2D STE indicators.

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