title: Right ventricular strain rate predicts clinical outcomes in patients with acute pulmonary embolism.
abstract: BACKGROUND
  Echocardiographic quantification of global and regional right ventricular (RV) function is critical in patients with acute pulmonary embolism (PE), but remains a challenge particularly in acute RV dilatation.
  
  
  METHODS
  Apical two-dimensional images of patients with acute PE were analyzed using both conventional and speckle tracking imaging compared with controls; patients with PE were divided into those who received thrombolysis and those who did not. The basal, mid and apical segments of the RV free wall and septum were analyzed. Correlations between speckle tracking measurements and in-hospital mortality were made.
  
  
  RESULTS
  53 patients with PE were compared with 15 controls. Of the PE patients, 98.1% were treated with systemic anticoagulation, 15.1% with thrombolysis; 38% required ICU admission and 5.6% died. Strain rate of the mid interventricular septum and strain of the basal and mid interventricular septal segments were significantly lower in patients with PE than control. However, strain rate of the basal RV free wall was higher than controls. In thrombolysed patients, basal RV free wall strain rate was lower than in non-thrombolysed patients. RV strain rate significantly correlated with in-hospital mortality.
  
  
  CONCLUSIONS
  Speckle tracking may be a sensitive tool for assessing RV dysfunction and predicting mortality in patients with PE in this pilot study.
authors: Divisions of Cardiovascular, Department of Medicine, Stony Brook University Medical Center, NY 11974-8167, USA. kathleen.stergiopoulos@stonybrook.edu
authors: Kathleen
authors: K
authors: Stergiopoulos
authors: Samira
authors: S
authors: Bahrainy
authors: Paul
authors: P
authors: Strachan
authors: Smadar
authors: S
authors: Kort
mesh_terms: D000328:Adult; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000150:complications*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality