Motion analysis of right ventricular dysfunction under mild or moderate pressure overload caused by acute pulmonary embolism

Acute pulmonary embolism (APE) is the third most common cause of death in the United States. Appearing as a sudden blockage in a major pulmonary artery, APE may cause mild, moderate or severe right ventricular (RV) overload. Although severe RV overload produces diagnostically obvious RV mechanical failure, little progress has been made in gaining a clinical and biophysical understanding of moderate and mild acute RV overload and its impact on RV functionality. In the research described here, we conducted a pilot study in pigs using echocardiography and observed the following abnormalities in RV functionality under acute mild or moderate RV overload: (i) occurrence of paradoxical septal motion with "waving" dynamics; (ii) decrease in local curvature of the septum (p<0.01); (iii) lower positive correlation between movement of the RV free wall and movement of the septum (p<0.05); (iv) slower rate of RV fractional area change (p<0.05); and (v) decrease in movement stability, particularly in the middle of the septum (p<0.05).