Second Department of Cardiology, University Hospital of Ioannina, 455 00 Ioannina, Greece.
Department of Physiology, Faculty of Medicine, University of Ioannina, 451 10 Ioannina, Greece.
Medicina (Kaunas). 2024 Sep 27;60(10):1586. doi: 10.3390/medicina60101586.
Pulmonary embolism (PE) is correlated with serious morbidity and mortality. Efforts have been made to establish and validate mortality predictive scores based mainly on clinical parameters. Patients with PE and traditional indices of echocardiographic right ventricular (RV) dysfunction or pressure overload have a higher probability of a worse outcome. During the last two decades, studies regarding the use of two-dimensional speckle-tracking echocardiography (2DSTE) and its derived indices in the setting of acute PE have been conducted. In this comprehensive review of the literature, we aimed to summarize these studies. Safe conclusions and comparisons among the reviewed studies are prone to statistical errors, mainly because the studies published were heterogenous in design, different 2DSTE-derived parameters were tested, and different clinical outcomes were used as endpoints. Nonetheless, RV strain indices and, more commonly, regional longitudinal strain of the RV free wall have shown a promising correlation with mortality, assisting in the differential diagnosis between PE and other acute or chronic disorders.
肺栓塞(PE)与严重的发病率和死亡率相关。人们已经努力建立和验证主要基于临床参数的死亡率预测评分。PE 患者和超声心动图右心室(RV)功能或压力超负荷的传统指标异常的患者,其预后更差的可能性更高。在过去的二十年中,已经进行了关于二维斑点追踪超声心动图(2DSTE)及其在急性 PE 中的衍生指数的研究。在对文献的全面综述中,我们旨在总结这些研究。由于发表的研究在设计上存在异质性,测试了不同的 2DSTE 衍生参数,并且使用不同的临床结局作为终点,因此,安全的结论和对综述研究的比较容易受到统计误差的影响。然而,RV 应变指数,更常见的是 RV 游离壁的局部纵向应变,与死亡率有很好的相关性,有助于 PE 与其他急性或慢性疾病的鉴别诊断。