To retrospectively determine whether three computed tomographic ct findings ventricular septal bowing vsb ratio between the diameters of right ventricle rv and left ventricle lv and embolic burden are associated with short term death defined as in hospital death or death within 30 days of ct whichever was longer due to acute pulmonary embolism pe.
Rv lv ratio pe radiology.
The right ventricular to left ventricular diameter rv lv ratio measured at ct pulmonary angiogram ctpa has been shown to provide valuable information in patients with pulmonary arterial hypertension and to predict death or deterioration in acute.
In the study by araoz et al 42 an rv lv diameter ratio greater than 1 was associated with a 3.
Ratio 0 9 considered positive.
The study authors found that greater clot volume was associated with a higher incidence of right heart dysfunction and that a right ventricle rv to left ventricle lv ratio that is greater.
Rvef was the best predictor for clinical outcome in patients with acute pe.
Rvef and rv lv ratio proved better predictors for outcome than pulmonary obstruction index both p 001.
Measurement made on axial imaging.
Patients with interstitial lung disease ild may develop pulmonary hypertension ph often disproportionate to the severity of the ild.
Lv and rv intracavitary diameter should be measured perpendicular to the long axis at the maximum measureable diameter.
Right ventricle left ventricle end diastolic basal diameter ratio 1 the right ventricular outflow tract is considered enlarged when the measured diameter in the parasternal long axis exceeds 3 3 cm or when the measured diameter exceeds 2 7 cm in the distal rvot as measured in the basal parasternal short axis view.
Additional studies have estimated that an rv lv diameter ratio superior to 1 5 indicates a severe episode of pe 36 39 41.
This retrospective cohort study included 579 consecutive subjects 08 2003 03 2010 diagnosed with acute pe with normal ct rv lv ratio 0 9 236.
Although the prevalence of rv dysfunction defined as a right to left ventricular rv lv diameter ratio 0 9 was lower than in previous studies for example 66 in unselected and 63 in normotensive pe patients a prevalence of 54 appears considerably high in an apparently healthy and haemodynamically stable cohort of pe patients.
Measurements will likely be on different axial images to obtain the true maximum measurement for each ventricle.
It occurs in a number of clinical scenarios including.
Right ventricular dysfunction usually results from either pressure overload volume overload or a combination.