Abstract 13154: Impact of Age for Right Atrial Strain in Patients With Submassive Pulmonary Embolism

Abstract

Background: Submassive pulmonary embolisms (sPE) are common and carry significant mortality. Strain imaging presents a novel method of assessing right atrial (RA) function. However, there are less reports focused on the feature of RA strain in patients with sPE. This study examines whether RA strain has different cutoff values according to aging in patients with sPE. Method: We performed a retrospective cohort study of 221 patients with sPE. The primary outcome was 30-day all-cause mortality. RA strain was analyzed retrospectively using TOMTEC ®. All patients were divided into three age groups according to tertiles. Receiver operating characteristic (ROC) curves were performed for evaluation. Result: Median age was 65 years and 31 patients died within 30 days. Of 221 patients, 84 patients (38%) were elder group (70 ≤ age), 66 patients (30%) were middle-aged group (58 ≤ age ≤ 69), and 71 patients (32%) were young group (age < 58). In all patients, statistical difference was observed in RA strain among the three groups (p = 0.042). ROC curve to predict 30-day mortality depicted area under the curve (AUC) and best cutoff value (BCV) were 0.688 and 27.7, respectively. (sensitivity [SE] 0.704, specificity [SP] 0.642) In elder group, ROC demonstrated AUC of 0.656 and BCV of 28.9 (SE 0.480, SP 0.889). In middle-aged group, ROC showed AUC of 0.647 and BCV of 27.7 (SE 0.636, SP 0.694). Interestingly, in young group, ROC demonstrated the lowest BCV of 17.4 with AUC of 0.75 (SE 0.571, SP 0.984) (Figure). Conclusion: RA strain as best cutoff shows different values among different age groups, especially low value in young groups. Further validation is needed to determine the role and utility of strain in patients with submassive PE.