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Right ventricular function in patients with pulmonary embolism: early and late findings using Doppler tissue imaging

Journal article
Authors R. Rydman
F. Larsen
Kenneth Caidahl
M. Alam
Published in Journal of the American Society of Echocardiography
Volume 23
Issue 5
Pages 531-7
ISSN 0894-7317
Publication year 2010
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 531-7
Language en
Links dx.doi.org/10.1016/j.echo.2010.03.0...
Keywords Echocardiography, Doppler/*methods, Elasticity Imaging Techniques/*methods, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pulmonary Embolism/*complications/*diagnostic imaging, Reproducibility of Results, Sensitivity and Specificity, Ventricular Dysfunction, Right/*diagnostic imaging/*etiology
Subject categories Cardiac and Cardiovascular Systems

Abstract

BACKGROUND: Assessments of right ventricular (RV) function using myocardial velocities in patients with pulmonary embolism (PE) may add vital information. METHODS: Thirty-four patients with PE were studied in the acute stage and 3 months afterward. Tricuspid annular velocity was recorded using pulsed-wave Doppler tissue imaging. RESULTS: At the time of diagnosis, tricuspid annular velocities were significantly decreased in patients compared with controls in systole (12.9 vs 14.8 cm/s, P < .05) and early diastole (11.9 vs 15.3 cm/s, P < .01) and normalized during follow-up. Decreases in tricuspid annular velocity were most pronounced in patients with increased RV pressure. The myocardial performance index was prolonged and pulmonary vascular resistance was higher in patients with increased RV pressure. The ratio of tricuspid flow to myocardial velocity (E/Em) was also increased compared with controls (4.5 vs 3.5, P < .05). CONCLUSION: RV dysfunction in patients with PE was common in the acute phase but normalized within 3 months. Patients presenting with normal RV pressure had normal systolic but disturbed diastolic function.

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