title: Right atrial and ventricular function evaluated with speckle tracking in patients with acute pulmonary embolism.
abstract: OBJECTIVE
  Assessment of right ventricular (RV) function in acute pulmonary embolism (PE) has prognostic significance. The aim of this study was to evaluate right atrium (RA) and RV myocardial damage with 2-dimensional speckle-tracking in patients with an acute central vs an acute peripheral PE.
  
  
  RESULTS
  Twenty-six patients with acute PE and 10 controls were retrospectively enrolled. Right atrium and RV myocardial deformation was analyzed using speckle-tracking imaging echocardiography. Parameters were evaluated to illustrate myocardial damage in patients with a central or a peripherally located PE. Thirteen of the enrolled patients had a massive central PE, and thirteen subjects had a peripheral located PE. Baseline characteristics were not significantly different between the 3 groups besides a more elevated heart rate among patients with a central PE (P = .02) and a tendency of an increased D-dimer in this group. Right ventricular dimensions were more affected among patients with a PE. Compared with controls, segmental RV and RA strain/strain rate in the free wall was significantly reduced in patients with PE (P < .05). No difference was shown between the 2 groups of PE.
  
  
  CONCLUSIONS
  This pilot study suggests that basal-/mid-segments of RA and RV free wall are more affected in patients with a PE compared with controls. Interestingly, we found no significant difference in myocardial RA and RV damage between patients with a central and a peripheral PE. We advocate that PE no matter central or peripheral is a serious condition and that a peripheral PE has to be intensively treated similar to a central PE.
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark. Electronic address: eram12@live.dk.
authors: Emilie
authors: E
authors: Ramberg
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Maria
authors: M
authors: Olausson
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Tem Bendix Salkvist
authors: TB
authors: Jørgensen
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Malene Lindholmer
authors: ML
authors: Nepper
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Priya
authors: P
authors: Bhardwaj
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Tomas Sorm
authors: TS
authors: Binko
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Jan Roland
authors: JR
authors: Petersen
authors: Department of Cardiology, Amager Hospital, Copenhagen, Denmark.
authors: Gitte Gleerup
authors: GG
authors: Fornitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016280:Atrial Function, Right; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology; D016278:Ventricular Function, Right
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D