Lower Right Ventricular Global Longitudinal Strain was significantly associated with ICU admission (13.4 vs 15.9; p=0.004) and the need for catheter embolectomy or TNK (12.2 vs 15.6; p=0.002).
Observational (n=90)
No
Does Right Ventricular Global Longitudinal Strain (RVGLS) predict clinical outcomes in patients with intermediate-risk pulmonary embolism?
Lower Right Ventricular Global Longitudinal Strain (RVGLS) is significantly associated with ICU admission, need for advanced therapies, and higher biomarker levels in patients with intermediate-risk pulmonary embolism.
p-value: p=0.004
Abstract Rationale Patients with pulmonary embolism (PE) are at increased risk for right ventricular (RV) dysfunction. Disease severity markers including vital signs, computed tomography (CT) and echocardiographic findings, and biochemical analyses have been used to risk-stratify PE. Traditional echocardiographic indices such RV diameter, tricuspid annular plane systolic excursion (TAPSE), and inferior vena cava (IVC) diameter are commonly used to evaluate RV function. However, due to the RV’s features including its thinner wall and unique geometry, these measures have limited ability to detect subtle dysfunction. Right Ventricular Global Longitudinal Strain (RVGLS), a measure of RV function utilizing strain echocardiography, may provide improved prognostic utility in patients with intermediate risk pulmonary embolism. We sought to evaluate the prognostic value of RVGLS in patients with intermediate-risk PE. Methods We conducted a single center retrospective analysis of 90 patients aged 18-80 years who presented with intermediate-risk pulmonary embolism between July 2024 and July 2025. All patients were managed through activation of the institutional Pulmonary Embolism Response Team (PERT). Clinical data and echocardiographic measurements were obtained through chart review and post-imaging processing. Statistical analyses, including two-tailed t-testing and Fisher’s exact testing, were performed to evaluate the association between RVGLS on echocardiography and clinical outcomes including ICU admission, mortality, and length-of-stay. Results Patients with intermediate-risk PE admitted to the ICU had significantly lower RVGLS compared to non-ICU patients (13.4 ± 3.99 vs 15.9 ± 3.87, p-=0.004). Patients receiving catheter embolectomy or TNK administration had significantly lower RVGLS values (12.2 ± 2.69 vs. 15.6 ± 4.11; p = 0.002). Patients in the lower quartile of strain (n = 22) had longer hospital stay (7.5 days ±7.6 vs 5.6 days ± 4.75; p = 0.316). These patients were more likely to undergo embolectomy or TNK administration than those at the higher quartile (8 vs 0; p = 0.001) and presented with significantly higher NT-pro BNP (5885pg/mL ± 7686 vs. 1267pg/mL ± 2488; p = 0.014) and troponin level (192ng/L ± 190 vs. 51ng/L ± 96; p = 0.004). Conclusion Our results suggest that RVGLS provides additional prognostic information beyond traditional echocardiographic indices in patients with intermediate-risk pulmonary embolism. Incorporating RVGLS into routine echocardiographic assessment may improve detection of RV dysfunction and enhance risk stratification in this population. Standardization of RVGLS measurement as part of the echocardiographic evaluation for intermediate-risk PE may assist in clinical decision making. This abstract is funded by: None
Koritysskiy et al. (Fri,) conducted a observational in Intermediate-risk pulmonary embolism (n=90). Right Ventricular Global Longitudinal Strain (RVGLS) was evaluated on Clinical outcomes including ICU admission, mortality, and length-of-stay (p=0.004). Lower Right Ventricular Global Longitudinal Strain was significantly associated with ICU admission (13.4 vs 15.9; p=0.004) and the need for catheter embolectomy or TNK (12.2 vs 15.6; p=0.002).
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