Assessment of Right Ventricular Function by Echocardiography in Patients with Pulmonary Embolism

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Avcı R., BAYAR N., ERKAL Z., Ersoysal M. R., Topcuoğlu B., Kumtaş F. H., ...Daha Fazla

International Journal of the Cardiovascular Academy, cilt.12, sa.1, ss.14-22, 2026 (Scopus)

Özet

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-high-risk patients, TT was associated with better preservation of RV systolic function, supporting its potential role in selected cases.