Cardiac strain in right ventricular myocardial infarction and pulmonary embolism

Abstract

Aim. To study the prospects of using parameters of right ventricle (RV) longitudinal strain (LS) during systole for the differential diagnosis of RV myocardial infarction (RVMI) and pulmonary embolism (PE).Material and methods. The study included 83 patients who were hospitalized with RVMI or PE in the period from December 2017 to May 2019. The study of RV LS using the two-dimensional speckle-tracking echocardiography was carried out in 30 patients with RVMI (group 1), 15 patients with high-risk PE (group 2), and 38 patients with intermediate-risk PE (group 3).Results. The mean values of RV global LS in patients of groups 1 and 2 did not differ (12,8±2,69 and 12,0±2,56%, respectively) and were significantly lower than in patients of group 3 (15,9±3,03%). The ratio of the interventricular septum (IVS) LS to the RV free wall (FW) LS in the group 1 (1,04±0,43) was significantly lower than in the groups 2 (1,61±0,52) and 3 (1,29±0,38). The ratio of the LS of the RVFW basal segment to the apical segment in group 1 (0,60±0,37) was also significantly lower than in groups 2 (1,69±1,57) and 3 (1,67±1,33).Conclusion. In patients with RVMI, there is a comparable decrease in the LS of the RVFW and IVS, and the LS of the basal segment decreases to a greater extent than the apical one. In patients with PE, the decrease in the LS of the RVFW is more pronounced than in IVS, and the LS of the apical segment decreases to a greater extent than the basal one. These differences can be used for the differential diagnosis of RVMI and PE.

Keywords

• right ventricular systolic strain
• right ventricular myocardial infarction
• pulmonary embolism