title: Sex-related changes in tissue Doppler imaging parameters among patients with acute pulmonary thromboembolism.
abstract: OBJECTIVE
  There are few studies evaluating serial changes in tissue Doppler imaging parameters in acute pulmonary thromboembolism. We aimed to compare these changes in male and female patients separately.
  
  
  METHODS
  Between September 2010 and September 2011, 41 of 64 hemodynamically stable acute patients with pulmonary thromboembolism were included in the study. Twenty-two healthy individuals served as a control group.
  
  
  RESULTS
  Compared to the control group, the acute pulmonary thromboembolism group had a lower tricuspid annular plane systolic excursion, basal peak systolic velocity of the tricuspid valvular annulus, right ventricular (RV) peak systolic strain, and RV peak systolic strain rate and a higher RV diameter, peak systolic pulmonary artery pressure, and RV myocardial performance index (P < .05). Values for these parameters were not different between men and women in the patient group. In men, compared to admission, predischarge echocardiography showed significant improvement in the tricuspid annular plane systolic excursion (mean ± SD, 16.08 ± 4.33 versus 19.29 ± 3.74 mm; P = .002), basal tricuspid annular peak systolic velocity (10.11 ± 3.66 versus 11.66 ± 3.38 cm/s; P = .007), and peak systolic strain (-13.00% ± 14.99% versus -23.20% ± 10.23%; P = .001), whereas in women, predischarge and 3-month follow-up echocardiography showed marked improvement in the tricuspid annular plane systolic excursion (17.50 ± 4.88 versus 19.79 ± 5.58 mm; P = .021) and peak systolic strain (-15.70% ± 13.52% versus -21.01% ± 10.57%, respectively; P= .045). Female patients did not show improvement in these parameters during hospitalization.
  
  
  CONCLUSIONS
  Patterns of changes in the RV function over time during a 3-month follow-up might differ between male and female patients with acute pulmonary thromboembolism, and the recovery process could be slower in women. Moreover, the midventricular peak systolic strain might be useful for serial evaluation of the recovery process.
authors.affiliation: Tehran Heart Center, Department of Echocardiography, Tehran University of Medical Sciences, North Kargar Street, Tehran 14117 13138, Iran., msahebjam@yahoo.com.
authors.forename: Yaser
authors.initials: Y
authors.lastname: Jenab
authors.forename: Neda
authors.initials: N
authors.lastname: Ghaffari-Marandi
authors.forename: Azam
authors.initials: A
authors.lastname: Safir
authors.forename: Gita
authors.initials: G
authors.lastname: Ejmalian
authors.forename: Arezou
authors.initials: A
authors.lastname: Zoroufian
authors.forename: Arash
authors.initials: A
authors.lastname: Jalali
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sahebjam
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001794:Blood Pressure; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012727:Sex Characteristics; D018608:Ultrasonography, Doppler / Q000379:methods*; D055815:Young Adult
keywords: pulmonary thromboembolism; strain; tissue Doppler imaging; ventricle