Low right ventricular septal strain (≤14.4%) was associated with a significantly higher risk of 30-day mortality compared to high right ventricular septal strain (HR 9.29) in patients with intermediate-risk pulmonary embolism.
Cohort (n=251)
No
Does right ventricular septal longitudinal strain predict 30-day mortality in patients with intermediate-risk pulmonary embolism?
Right ventricular septal longitudinal strain ≤14.4% is a strong independent predictor of 30-day mortality in patients with intermediate-risk pulmonary embolism.
Effect estimate: HR 9.29 (95% CI 4.29-20.7)
p-value: p=<0.001
BACKGROUND: The interventricular septum contributes 30-60% of right ventricular (RV) output. However, few studies have assessed the prognostic value of RV septal strain in pulmonary embolism (PE). We hypothesized that RV septal strain would predict 30-day mortality in patients with intermediate-risk PE. METHODS AND RESULTS: This retrospective cohort study analyzed consecutive patients with intermediate-risk PE admitted to the Penn State Health Milton S. Hershey Medical Center between 2010 and 2018. The primary outcome was 30-day all-cause mortality. RV septal strain was measured within the RV endocardium and was defined as the mean of basal, mid, and apical septal longitudinal strain. Among 251 patients, 31 (12.4%) died within 30 days of PE diagnosis. RV strain analysis was feasible in 230 (91.6%) patients. RV septal strain was significantly lower in those who died and was independently associated with 30-day mortality (P14.4%) RV septal strain (hazard ratio 9.29; P<0.001). CONCLUSIONS: RV septal strain is a feasible and reproducible parameter with strong prognostic value in patients with intermediate-risk PE. These findings highlight the central role of the interventricular septum in RV function and risk stratification.
Eguchi et al. (2026) conducted a cohort in Intermediate-risk pulmonary embolism (n=251). Low right ventricular septal strain (≤14.4%) vs. High right ventricular septal strain (>14.4%) was evaluated on 30-day all-cause mortality (HR 9.29, 95% CI 4.29-20.7, p=<0.001). Low right ventricular septal strain (≤14.4%) was associated with a significantly higher risk of 30-day mortality compared to high right ventricular septal strain (HR 9.29) in patients with intermediate-risk pulmonary embolism.