الفهرس 
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Abstract
Systematic reviews and meta-analyses have suggested that RV dysfunction on echocardiography is associated with an elevated risk of short-term mortality in patients who appear hemodynamically stable at presentation (non-massive pulmonary embolism), but its overall positive predictive value for PE-related death was low (<10%) in a meta-analysis. There are many methods for assessing RV function; however, no single measurement is accepted as a gold standard. Recently, novel methods for quantitative assessment of myocardial function have been developed: tissue Doppler imaging (TDI) and speckle tracking echocardiography (STE). Speckle tracking echocardiography overcomes most of the limitations inherent in conventional echocardiography, thus allowing accurate quantification of regional and global myocardial function.
So, this study aimed to evaluate right ventricular function in patients with non-massive pulmonary embolism using tissue Doppler and speckle tracking echocardiography.
This study included 100 patients with non-massive pulmonary embolism that has been admitted at Benha University Hospital.
They were assessed for baseline characteristics, vital signs, Tropnin I,D-Dimer levels, pulmonary embolism severity index, echocardiography, anticoagulant used in treatment, duration of hospital stay & in hospital events.
In the current study, there was no significant statistical difference between the 2 groups regarding the age (p=0.67). Also, there was no significant statistical difference between the 2 groups regarding the heart rate (p=0.135).
In the current study, PESI score was significantly higher in group I compared to group II (P < 0.001) and there was a significant statistical difference between the 2 groups as regarding PESI class>III (P = 0.003).
In the current study, there was a significant statistical difference between the 2 groups as regarding use of LMWH (p value=0.015)
In the current study, mean right ventricular free wall strain was significantly reduced in patients of group I compared with group II patients (P < 0.001).
In the current study, mean right ventricular global wall strain was significantly reduced in patients of group I compared with group II patients (P < 0.001).
In the current study, mean FAC was significantly lower in patients of group I compared with group II patients (P < 0.001)
In the current study, mean TAPSE was significantly lower in patients of group I compared with group II patients (P=0.003).
In the current study, mean S velocity was significantly lower in patients of group I compared with group II patients (P= 0.001).
According to multivariate logistic regression analysis, predictors for in-hospital event were RV free wall strain (P=0.006), RV global wall strain (P=0.008), FAC (P=0.012) and S velocity (P=0.012).
FAC showed significant positive correlation with RV free wall strain (P= 0.002) & with RV global strain (P = 0.001).
TAPSE showed significant positive correlation with RV free wall strain (P= 0.006) & with RV global strain (P= 0.017).
RIMP showed significant negative correlation with RV free wall strain (P= 0.024) & with RV global strain (P= 0.013)
RV free wall strain showed significant AUC of 0.964. Best cutoff was ≤-14.6 at which sensitivity and specificity were 100% and 87.4% respectively. P value was <0.001.
RV global wall strain showed significant AUC of 0.956. Best cutoff was ≤-14.3 at which sensitivity and specificity were 100% and 86.2% respectively. P value was <0.001.
FAC showed significant AUC of 0.829. Best cutoff was ≤ 38 at which sensitivity and specificity were 84.6% and 71.3% respectively. P value was <0.001.
TAPSE showed significant AUC of 0.754. Best cutoff was ≤ 1.6 at which sensitivity and specificity were 76.9% and 75.9% respectively. P value was 0.003.
S velocity showed significant AUC of 0.779. Best cutoff was ≤ 11 at which sensitivity and specificity were 69.2% and 88.5% respectively. P value was