Right Ventricular Function in Patients With Pulmonary Embolism: Early and Late Findings Using Doppler Tissue Imaging

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.

Keywords: Pulmonary embolism, Right ventricular function, Echocardiography, Doppler tissue imaging

Abbreviations: DTI, Doppler tissue imaging, E, Early diastolic inflow velocity, E/Em, Ratio of tricuspid flow to myocardial velocity, MPI, Myocardial performance index, PE, Pulmonary embolism, PVR, Pulmonary vascular resistance, RV, Right ventricular, TAPSE, Tricuspid annular plane systolic excursion, TRV, Tricuspid regurgitation velocity, TVI_ROT, RV outflow tract time-velocity integral, WU, Wood units