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Vector velocity imaging echocardiography to study the effects of submassive pulmonary embolism on the right atrium
Author(s) -
Khan Umar A.,
Aurigemma Gerard P.,
Tighe Dennis A.
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13753
Subject(s) - cardiology , medicine , pulmonary embolism , pulmonary artery , right atrium , left atrium , velocity vector , area under the curve , atrial fibrillation , engineering , aerospace engineering
Objectives To assess the effects of submassive pulmonary embolism ( SMPE ) on right atrial ( RA ) anatomy and function. Background Right ventricular dysfunction ( RVD ) is associated with adverse outcomes in SMPE . However, the effects of SMPE on the structure and function of the RA have received much less attention. Methods Fifty patients with SMPE documented by CT angiography ( SMPE group) and evidence of RVD on two‐dimensional echocardiography were retrospectively identified and compared to 50 controls (control group). Both RA and RV areas, volumes and fractional area change ( FAC ) were measured. Pulmonary artery systolic pressures were estimated. RA and RV longitudinal strains were obtained using vector velocity imaging ( VVI ). Results Compared with controls, RA and RV FAC s were significantly reduced and associated with higher chamber volumes in the SMPE group. Global longitudinal RA strain was reduced in the SMPE group (29% + 11% vs 55% + 16%; P < .01), as was global RV longitudinal strain (−12% + 5% vs −20% + 5%, P < .01), when compared to the controls. A linear relationship existed between RV and RA strain in both groups; however, the curve was shifted downward among those with SMPE . Furthermore, ROC curve analysis suggests RA area performs better than RV area as a marker of SMPE . Conclusions RA structure and function are adversely affected in SMPE , similar to the effects observed in RV . Lower RA strain appears to be a novel quantitative indicator of SMPE , and RA area may be a more sensitive marker of this condition and may provide additional prognostic information in this condition.