Reversible right ventricular regional non-uniformity quantified by speckle-tracking strain imaging in patients with acute pulmonary thromboembolism.
BACKGROUND
The aim of this study was to evaluate the effects of acute right ventricular (RV) pressure overload (RVPO) on RV systolic function and its regional uniformity using speckle-tracking strain analysis in patients with acute pulmonary thromboembolism (APTE).


METHODS
Twenty-three patients with APTE (mean age, 59 +/- 16 years) and 23 age-matched and gender-matched normal subjects (the control group) were examined using echocardiography. Global and segmental longitudinal RV peak systolic strain (PSS) was analyzed using speckle-tracking strain echocardiography. The heterogeneity of RV regional function was assessed by calculating the standard deviation from 6-segmental PSS divided by the absolute value of global PSS. The standard deviation of the heart rate-corrected intervals from QRS onset to PSS for the 6 segments was used to quantify RV dyssynchrony.


RESULTS
Patients with APTE had reduced regional PSS, resulting in reduced global PSS and augmented regional heterogeneity, and had delayed myocardial contraction in the basal and mid RV lateral walls, resulting in large dyssynchrony (global PSS, -14 +/- vs -25 +/- 3%; heterogeneity, 0.54 +/- 0.26 vs 0.24 +/- 0.09; dyssynchrony, 91 +/- 38 vs 25 +/- 10 ms; P < .05 vs controls for all comparisons). After the amelioration of acute RVPO by primary treatment, both RV heterogeneity and dyssynchrony returned to normal values.


CONCLUSIONS
Speckle-tracking strain echocardiography can effectively quantify reversible RV regional nonuniformity caused by acute RVPO and can characterize the pattern of RV regional impairment in patients with APTE.
Sugiura
Emiyo
E
Mie University Graduate School of Medicine, Tsu, Japan.
Dohi
Kaoru
K
Onishi
Katsuya
K
Takamura
Takeshi
T
Tsuji
Akihiro
A
Ota
Satoshi
S
Yamada
Norikazu
N
Nakamura
Mashio
M
Nobori
Tsutomu
T
Ito
Masaaki
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology*; D055815:Young Adult