Evaluation of right ventricular function by three-dimensional speckle tracking imaging in patients with acute pulmonary embolism

  AIM  To assess the right ventricular function by three-dimensional speckle tracking imaging in patients with acute pulmonary embolism.

  METHODS  16 patients with acute pulmonary embolism diagnosed in Nanjing First Hospital were selected as APE group and 16 healthy volunteers as control group. The new right ventricular 3D-STI technique was used to measure and compare the right ventricular end systolic volume (RVESV), right ventricular end diastolic volume (RVEDV), right ventricular ejection fraction (RVEF), right ventricular global longitudinal strain (RVGLS) and right ventricular global circumferential strain (RVGCS) between the two groups, and analyze the correlation between RVGLS and RVEF. According to the human anatomy of the right ventricle, the right ventricular myocardium is divided into seven myocardial segments, namely the inflow tract lateral wall (ITL), the inflow tract in front wall (ITI) and the inflow tract septal wall (ITS), the outflow tract free wall (OTF) and the outflow tract septal wall (OTS), Apex free wall (AF) and apex septal wall (AS). The new right ventricular 3d-sti technique was used to measure and compare the longitudinal and circumferential strains of 7 segments of right ventricle between the two groups.

  RESULTS  Compared with the control group, the RVEDV and RVESV of APE group increased, the RVEF decreased, and the absolute values of RVGLS decreased, all P<0.05, but there was no significant difference between RVGCS and the control group. Comparison of longitudinal and circumferential strain values of 7 segments of right ventricle between the two groups: among the longitudinal myocardial strain values, the absolute values of longitudinal strain values of 6 segments in APE group except apical septum (AS) were significantly lower than those in the control group (P<0.05). Among the circumferential myocardial strain values, the absolute values of myocardial strain values in APE group were significantly lower only in the lateral wall of inflow tract (ITL), anterior wall of inflow tract (ITI) and septal wall of inflow tract (ITS) (P<0.05). Pearson correlation analysis showed that there was a negative correlation between RVGLS and RVEF in the control group (r=−0.58, P<0.05); There was a negative correlation between RVGLS and RVEF in APE group (r=−0.54, P<0.05).

  CONCLUSION  The right ventricular systolic function of APE patients is significantly reduced and 3D-STI could be used to detect and evaluate the right ventricular function.