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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 1, January/February 2020
24
AFRICA
pressure, and CTA revealed larger RV diameters and higher RV/
LV ratio (
p
=
0.002), and greater superior vena cava, azygos vein
and coronary sinus diameters. PA diameter and PA/AO ratio
were similar.
In addition, the correlation between clot burden and
echocardiographic regional RV dysfunction (RRVD) was studied
by Tuzovic
et al.
14
RRVD was defined as normal excursion of
the apex, contrasting with hypokinesis of the mid free-wall
segment. RV assessment included measurements of ventricular
dimensions, fractional area change, free-wall longitudinal strain
and TAPSE. The results of that study showed that regional RV
dysfunction was associated with an increased clot burden in
acute PE and was more prevalent among patients with moderate
to severe RV enlargement.
Conclusion
In patients with acute PE, the assessment of right-sided cardiac
dysfunction using pulmonary CTA showed a good correlation
with clot burden. On the other hand, some commonly used
echocardiographic parameters did not show a good correlation
between RV dysfunction and clot burden. Despite its essential
role in the assessment and diagnosis of acute PE, some common
and routinely used echocardiographic parameters should not
be used alone to judge the impact of PE with regard to RV
dysfunction. It is suggested that pulmonary CTA parameters be
used to adequately assess sequela of PE on RV function.
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