Midventricular peak systolic strain and Tei index of the right ventricle correlated with decreased right ventricular systolic function in patients with acute pulmonary thromboembolism.

BACKGROUND: Assessment of right ventricular (RV) systolic function remains difficult because of the RV's complex shape. We aimed to evaluate RV systolic function with strain analysis in patients with acute pulmonary thromboembolism (PTE).

PATIENTS AND METHODS: From March 2005 to June 2006, 28 consecutive patients with acute PTE were included in this study. After excluding four patients, three with recurrent episodes of PTE and one with permanent pacemaker, the remaining 24 patients (10 males, mean age 69.0+/-10 years) were analyzed.

RESULTS: Mean RV fractional area change (RVFAC) was 20.1+/-8.7%; RV Tei index was 0.86+/-0.23; tricuspid annular plane systolic excursion (TAPSE) was 1.56+/-0.31 cm; and TR Vmax was 3.6+/-0.4 m/s at the time of diagnosis. Midventricular peak systolic strain of RV was markedly decreased (base: -18.0+/-6.6%, midventricle: -5.4+/-12.8%, apex: -10.6+/-8.1%). After treatment, follow-up echocardiographic data were obtained from 20 patients (mean: 11.0+/-8.2 days, duration: 4-34 days). Mean RVFAC, RV Tei index, TAPSE and TR Vmax were significantly improved (P<0.001). Midventricular peak systolic strains of RV were also significantly improved (base: -20.9+/-7.0%, P=0.055, midventricle: -21.1+/-6.8%, P<0.001, apex: -12.7+/-8.1%, P=0.314). Midventricular peak systolic strain of RV showed significant negative correlation with RVFAC (r=-0.660, P<0.001) and TAPSE (r=-0.642, P<0.001). Also, the RV Tei index showed significant correlation with RVFAC (r=-0.646, P<0.001) and TAPSE (r=-0.647, P<0.001).

CONCLUSIONS: Midventricular peak systolic strain and RV Tei index decreased in the patients with acute PTE and improved after stabilization. These values can therefore be used to assess RV systolic function in patients with acute PTE.