Association between anatomical location of lower extremity deep vein thrombosis and right ventricular strain parameters after acute pulmonary thromboembolism

This study investigated the relationship between the anatomical location of lower extremity deep vein thrombosis (DVT) and the levels of brain natriuretic peptide (BNP) and right ventricular echocardiographic parameters after acute pulmonary thromboembolism (APTE). This study included 231 first-time APTE patients admitted between October 2013 and August 2020. Based on lower limb vascular ultrasound findings, patients were categorized into four groups: leg intermuscular vein thrombosis ( n = 94), tibiofibular vein thrombosis ( n = 31), femoral popliteal vein thrombosis ( n = 90), and inferior iliac vein thrombosis ( n = 16). Clinical data, BNP levels, and echocardiographic parameters, including pulmonary artery systolic pressure (PASP), pulmonary artery trunk width, right ventricular outflow tract width, and right ventricular diameter, were analyzed and compared among groups. Baseline characteristics were comparable across groups. BNP levels, PASP, pulmonary artery trunk width, right ventricular outflow tract width, and right ventricular diameter were significantly higher in the legintermuscular vein thrombosis group and the tibiofibular vein thrombosis group compared to the femoral popliteal vein thrombosis group and the inferior iliac vein thrombosis group ( P < 0.05). A significant positive correlation was found between DVT location and pulmonary artery trunk width ( r = 0.654), right ventricular outflow tract width ( r = 0.582), and right ventricular diameter ( r = 0.741) (all P = 0.001). Patients with distal DVT (leg veins) exhibited a higher proportion of moderate to severe pulmonary hypertension. The anatomical location of DVT, particularly leg vein thrombosis, is significantly associated with the degree of right ventricular strain after APTE. Echocardiographic parameters and BNP levels may help stratify patients based on DVT location and PH severity.