Right Ventricular Function in Patients With Pulmonary Embolism: Early and Late Findings Using Doppler Tissue Imaging
published online 12 April 2010.
Background
Assessments of right ventricular (RV) function using myocardial velocities in patients with pulmonary embolism (PE) may add vital information.
Methods
Thirty-four patients with PE were studied in the acute stage and 3 months afterward. Tricuspid annular velocity was recorded using pulsed-wave Doppler tissue imaging.
Results
At the time of diagnosis, tricuspid annular velocities were significantly decreased in patients compared with controls in systole (12.9 vs 14.8 cm/s, P < .05) and early diastole (11.9 vs 15.3 cm/s, P < .01) and normalized during follow-up. Decreases in tricuspid annular velocity were most pronounced in patients with increased RV pressure. The myocardial performance index was prolonged and pulmonary vascular resistance was higher in patients with increased RV pressure. The ratio of tricuspid flow to myocardial velocity (E/Em) was also increased compared with controls (4.5 vs 3.5, P < .05).
Conclusion
RV dysfunction in patients with PE was common in the acute phase but normalized within 3 months. Patients presenting with normal RV pressure had normal systolic but disturbed diastolic function.
aClinical Physiology Section, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
bCardiology Section, Department of Clinical Sciences, Danderyd, Karolinska Institutet, Stockholm, Sweden
cDepartment of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden
Reprint requests: Riikka Rydman, MD, Karolinska Institutet, Department of Clinical Physiology N2:01, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
This study was partly supported by the Stockholm County Council, the Swedish Research Council, and the Swedish Heart Lung Foundation (Stockholm, Sweden).
ABSTRACT