Application Of Echocardiography To Assess Right Heart Function In Pulmonary Embolism

Objective:To investigate the correlation between risk stratification and echocardiographic and laboratory indices in patients with pulmonary embolism(PE)and to provide a basis for rapid clinical diagnosis,right heart function was assessed by 2D echocardiography,M-mode echocardiography,and Doppler echocardiography in patients with PE at each risk level.Materials and Methods:Forty patients with pulmonary embolism diagnosed by CT pulmonary angiography(CTPA)between September 2022 and January 2023 at ChinaJapan Union Hospital of Jilin University were collected,including 24 men and16 women aged 36-81 years,with a mean age of(63.2 ± 13.8)years.Patients with pulmonary embolism were classified into risk groups according to the new edition of the guidelines for the management of pulmonary embolism published by the European Society of Cardiology(ESC)in the European Heart Journal 2019.Patients were divided into three groups: low risk(18patients),intermediate risk(12 patients)and high risk(10 patients).The echographic and laboratory indices of all patients were analysed to determine the correlation between risk stratification and echocardiographic and laboratory indices in patients with pulmonary embolism.RESULTS:1)There were significant differences in heart rate,B-typeinal peptide(BNP),cardiac troponin(c Tn I)and D-dimers between the low,intermediate and high risk groups of PE patients.2)There were significant differences in inferior vena cava diameter(IVC),tricuspid early peak diastolic velocity/late peak diastolic peak velocity(E/A)between low-risk,intermediate-risk and high-risk groups of patients with pulmonary embolism.3)The differences in tricuspid regurgitation velocity(TRV),tissue doppler-derived right ventricular systolic excursion velocity(S′),ratio of right ventricular end-diastolic anteroposterior diameter to left ventricular enddiastolic anteroposterior diameter(RV/LV),tricuspid annular plane systolic excursion(TAPSE),main pulmonary artery diameter(PAD),left ventricular end-diastolic basal segmental transverse diameter(RV transverse diameter),right atrial end-systolic long diameter(RA long diameter),and right atrial end-systolic transverse diameter(RA transverse diameter)were statistically significant between the low-risk,intermediate-risk,and high-risk groups for pulmonary embolism.,and the differences in right ventricular myocardial work index(Tei),right ventricular fractional area change(RVFAC),left ventricular end-diastolic basal segment transverse diameter(LV transverse diameter),left ventricular end-diastolic long diameter(LV long diameter),right ventricular end-diastolic long diameter(RV long diameter),left atrial end-systolic transverse diameter(LA transverse diameter),left atrial endsystolic long diameter(LA long diameter)and right ventricular free wall thickness(RVWT)were not statistically significantly associated with risk stratification.TRV,RV/LV,TAPSE,PAD,RV transverse diameter,RA long diameter,and RA transverse diameter were significantly associated with risk stratification.4)Heart rate,BNP,c Tnl,D-dimer,E/A,IVC,TRV,RV/LV,S′,TAPSE,PAD,RV transverse diameter,RA longitudinal diameter and RA transverse diameter in patients with pulmonary embolism had a diagnostic effect in the low-risk group versus medium-risk and above group,and BNP,D-dimer,E/A,IVC and TRV were found to have superior diagnostic efficacy.Conclusion:1)Two-dimensional echocardiography,M-mode echocardiography and Doppler echocardiography provide a non-invasive,accurate and timely assessment of changes in right ventricular function in patients with pulmonary embolism and represent an important value and basis for clinical risk stratification.2)Risk stratification correlates with heart rate,echocardiographic indices and laboratory values in patients with pulmonary embolism.