Right Ventricular Global Longitudinal Strain and 30‐Day Mortality in Intermediate‐Risk Pulmonary Embolism: An External Validation Study

Le résumé fourni par la source

BACKGROUND: Intermediate-risk pulmonary embolism (PE) carries substantial short-term mortality. Our group previously demonstrated that right ventricular global longitudinal strain (RVGLS) predicted 30-day mortality in a single-center cohort using data collected before contemporary guideline updates, identifying a cutoff value of 17.7%. However, its prognostic value in contemporary external cohorts remains uncertain. We aimed to externally validate the association between RVGLS and 30-day mortality in an independent cohort. METHODS: We performed a retrospective cohort study of 119 patients with intermediate-risk PE treated between 2019 and 2022 at an independent institution. The primary outcome was all-cause 30-day mortality. Clinical and echocardiographic parameters were compared between survivors and non-survivors. Receiver operating characteristic and Kaplan-Meier analyses were used to assess prognostic performance. RESULTS: The mean age was 66.1 years, and 48.7% were female. Six patients (5.0%) died within 30 days. RV strain analysis was feasible in 110 patients (92.4%). Non-survivors had lower RVGLS (17.3% vs. 19.6%, p = 0.013). In univariable analysis, RVGLS was associated with mortality (odds ratio 0.567, p = 0.033). RVGLS demonstrated discriminatory performance for 30-day mortality, with an area under the curve of 0.802. Using the previously established cutoff of 17.7%, patients with reduced RVGLS had higher 30-day mortality (Log-rank p = 0.042). CONCLUSIONS: In this external cohort, RVGLS ≤ 17.7% was associated with increased 30-day mortality, supporting the prognostic value of the previously established threshold beyond the original derivation cohort.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.