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Updated: Sep 11, 2026
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Right Ventricular Global Longitudinal Strain and 30-Day Mortality in Intermediate-Risk Pulmonary Embolism: An
Shunsuke Eguchi1, Ayumi Eguchi1, Yoshiyuki Orihara1
1Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA.
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.
