Right Ventricular Myocardial Global Longitudinal Strain Assessment of Right Ventricular Function in Patients with Pulmonary Embolism

Objective To explore the clinical application value of right ventricular (RV) myocardial global longitudinal strain
(RVGLS) in assessing changes in RV function in patients with pulmonary embolism.
Material and methods Patients with pulmonary embolism who were treated successfully in our hospital from January 2022 to
December 2023 were enrolled in this study. Included were 34 pulmonary embolism patients without pulmonary hypertension (Group B), 31 with pulmonary hypertension (Group C), and 35 healthy volunteers, matched by gender and age (Group A). Clinical data and RV function-related variables of these groups were compared.
Results Compared with pre-treatment values of Group A, the following variables of Groups B and C had higher pre-treatment values (p<0.05): RV end-diastolic diameter (RVEDD), RV to left ventricular diameter ratio (RV / LV), RV work index (RIMP), main pulmonary artery diameter (MPA), pulmonary artery systolic pressure (PASP), RVGLS, RV free wall longitudinal strain (RVFWLS),
The following variables had lower values (p<0.05): RV area change fraction (RVFAC), RV ejection fraction (RVEF), RV short-axis shortening rate (RVFS), tricuspid annular peak systolic velocity (S’), tricuspid annular systolic excursion (TAPSE). After therapy, significant differences were observed in the aforementioned indicators between Group C (with pulmonary hypertension) and Group A (healthy controls), with Group C showing persistently elevated RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, alongside reduced RVFAC, RVEF, RVFS, S’, and TAPSE compared to Group A (all p<0.05). Compared to pre-treatment values in Group B (without pulmonary hypertension), pre-treatment Group C demonstrated significantly higher RVEDD, RV / LV ratio, RIMP, MPA, PASP, RVGLS, and RVFWLS, and significantly lower RVFAC, RVEF, RVFS, S’, and TAPSE (all p<0.05). Post-treatment comparisons between Groups B and C revealed that these differences remained significant (all p<0.05). ROC curve analysis revealed that RVGLS> 20.59 % is the best cutoff value for predicting the occurrence of pulmonary embolism, and RVGLS> –17.42 % is the best cutoff value for predicting the occurrence of pulmonary hypertension in patients with
pulmonary embolism. The results of multivariable logistic regression model analysis showed that RVGLS>–20.59 % is independently related to the occurrence of pulmonary embolism, and RVGLS>–17.42 % is independently related to pulmonary embolism complicated by pulmonary hypertension (p<0.05). In Groups A and B, RVGLS was negatively correlated with RVFAC, RVEF, and TAPSE (p<0.05 for all) and positively correlated with RIMP and PASP (p<0.05 for all). In Groups B and C, RVGLS was negatively correlated with RVFAC and RVEF in patients with pulmonary embolism before and after treatment (for all <0.05) and positively correlated with RIMP and PASP (p<0.05 for all).
Conclusion RVGLS can be applied to evaluate the RV function of patients with pulmonary embolism. RVGLS>–20.59 % is independently related to pulmonary embolism, and there is a significant correlation between RVGLS and RVVFAC, RVEF, RIMP, and PASP in patients with pulmonary embolism before and after treatment.

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