Evaluation of Predictive Value of CT Pulmonary Angiography for Right Ventricular Failure in Patients with Pulmonary Embolism

Abstract

Purpose: Right ventricle failure is a well-known complication following pulmonary thromboembolism. Although Computed Tomography Pulmonary Angiography (CTPA) findings are supposed to be a surrogate for patients’ outcome, investigations based on this issue is not still elucidated. Thus, in the current study, we assessed patients’ CTPA findings and compared the result with echocardiographic findings.

Materials and Methods: A total of 36 patients with proven pulmonary thromboembolism were enrolled and a comparison was made between indices in CTPA (interventricular septal deviation to the right side, inferior vena cava contrast reflux, and right ventricle diameter to left ventricle diameter ratio) and echocardiographic findings for detecting right ventricular failure. Also, the reliability of the aforementioned indices was sought for predicting mortality.

Results: No significant correlation was found between CTPA indices and echocardiographic findings. The highest sensitivity and positive predictive value in CT pulmonary angiography for detecting right ventricle dysfunction were revealed to be for Right Ventricle Diameter (RVD)/Left Ventricle Diameter (LVD)>1 (63.64%), abnormal septal deviation (75.00%), respectively.

Conclusion: Our results revealed that CTPA indices can reliably predict the upcoming mortality risk. On the other hand, these indices were not well-correlated with echocardiographic findings.