Temporal interpretation of right ventricular strain after pulmonary embolism

Abstract

Farmakis and colleagues assessed right ventricular (RV) strain in 175 survivors of acute pulmonary embolism (PE). 1 Sixteen participants developed post-PE impairment (PPEI) or chronic thromboembolic pulmonary hypertension (CTEPH) during follow-up. Three-month RV global longitudinal strain was asso - ciated with the combined outcome over 2 years (odds ratio 1.10, 95% confidence interval 1.01–1.21). 1 The timing of outcome onset relative to the 3-month scan determines the clinical interpretation of this association. In the parent FOCUS study, PPEI was a combination of persistent or worsening clinical, functional, biochemical, and imaging abnormalities assessed during follow-up. 2 Some participants may therefore have met PPEI criteria by the time of the three-month echocardiogram. CTEPH can likewise be recognized during early follow-up. 2 If the outcome includes abnormalities already present at the index scan, the strain measurement may characterize concurrent impairment rather than