Does thrombolytic therapy improve right ventricular free wall longitudinal strain in patients with intermediate-high-risk pulmonary embolism?
In patients with intermediate-high-risk pulmonary embolism, thrombolytic therapy was associated with significantly better right ventricular systolic function as measured by echocardiographic longitudinal strain.
Background and Aim: Pulmonary embolism (PE) is a cardiovascular disease associated with significant morbidity and mortality.Right ventricular (RV) dysfunction is a major determinant of prognosis in PE, and echocardiography is a key tool for assessing RV function.This study aimed to evaluate RV function by echocardiography in patients with intermediate-high-risk PE, with particular attention to the effect of thrombolytic therapy (TT). Materials and Methods:This retrospective, observational, comparative cohort study included 36 patients diagnosed with intermediate-high-risk PE between 2017 and 2019.The diagnosis of PE was confirmed by computed tomographic angiography or ventilation-perfusion scintigraphy.Echocardiographic assessment included RV free wall longitudinal strain (RVFWLS), and functional capacity was measured by the 6-minute walk distance (6MWD).Patients were divided into TT and non-TT groups for comparison. Results:Of 36 patients diagnosed with intermediate-high-risk PE, 58.3% (n=21) received TT, while 41.7% (n=15) did not receive this treatment.The mean RVFWLS was -29.76% in the TT group and -22.8% in the non-TT group (P = 0.012).The mean 6MWD was 434 m in the group receiving TT and 357 m in the group not receiving TT.Although 6MWD was higher in the TT group, the difference was not statistically significant (P = 0.179). Conclusion:Echocardiographic evaluation provides valuable insight into RV function in patients with PE.In this cohort of intermediate-highrisk patients, TT was associated with better preservation of RV systolic function, supporting its potential role in selected cases.
Avcı et al. (Mon,) studied this question.