Abstract 15135: Right Ventricular Longitudinal Strain Post-Acute Pulmonary Embolism is an Independent Predictor of Mortality

IntroductionRight Ventricular (RV) dysfunction is associated with morbidity and mortality in patients with pulmonary embolism (PE). Speckle-Tracking Endocardial Global Longitudinal Strain (Endo-GLS) is a sensitive technique that can detect early mechanical changes involving the RV and allow for quantification of RV systolic function.HypothesisRV Endo-GLS post-acute PE is an independent predictor of mortality at one year.MethodsWe performed a retrospective cohort study of 74 patients who presented with an acute PE to Montefiore Medical Center (Bronx, NY) in 2017 and had a transthoracic echocardiogram within 48 hours of indexed event. Speckle-Tracking Endo-GLS was performed using TomTec®. The study cohort was divided into RV strain tertiles (lowest -8.53). We compared baseline clinical and echocardiographic characteristics between each tertile. We calculated unadjusted and adjusted odds ratios using one-year all-cause mortality as outcome. Statistical analysis was done using R version 3.6.0.ResultsBaseline characteristics were similar between the tertiles including sex (p=0.61), age (p=0.18), diabetes mellitus (DM, p=0.98), chronic obstructive pulmonary disease (COPD, p=0.70), body-mass index (BMI, p=0.17), end-stage renal disease (ESRD, p=0.14), history of malignancy (p=0.76), PE size (p=0.71) and intervention (p=0.68). The middle tertile had significantly higher proportion of patients with hypertension (HTN, p=0.045). Patients in the lowest RV strain tertile had greater than 4 times higher one-year mortality compared to the highest tertile in all adjusted models (Table).ConclusionsWe demonstrated that RV Endo-GLS post-acute PE is an independent predictor of mortality at one year. Strain analysis in the acute period post-PE may be a useful modality to risk stratify patients who may be hemodynamically stable but are at increased risk of death