Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography: Prediction of adverse outcome and 30-day mortality.
OBJECTIVE
The aim of this study was to examine the association between right atrium (RA) and right ventricle (RV) diameters on computed tomography (CT) pulmonary angiography in response to acute pulmonary embolism (APE), in addition to 30-day mortality and adverse outcomes in patients with APE.


METHODS
This retrospective study was accepted by the institutional ethics committee. From January 2013 to March 2014, 79 hospitalized adult patients with symptomatic APE were included. Inclusion criteria were a CT pulmonary angiography positive for pulmonary embolism, availability of patient records, and a follow-up of at least 30 days. A review of patient records and images was performed. The maximum diameters of the heart chambers were measured on a reconstructed four-chamber heart view, and the vascular obstruction index was calculated on CT pulmonary angiography.


RESULTS
There were statistically significant relationships in both the RA/RV diameter ratio and the RV/left ventricle (LV) diameter ratio between patients with and without adverse outcomes (p<0.001 and 0.002, respectively). Furthermore, there was a statistically significant difference in the RA/RV diameter ratio, but not in the RV/LV diameter ratio, between those with and without 30-day mortality (p=0.002 and 0.148, respectively).


CONCLUSIONS
Measurement of the RA/RV diameter ratio may be an alternative and useful method for predicting 30-day mortality and adverse outcome in patients with APE.
Bulent Ecevit University, School of Medicine, Department of Radiology, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: ilkeroz@yahoo.com.
Ibrahim Ilker
II
Oz
Bulent Ecevit University, School of Medicine, Department of Pulmonology, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: altinsoyb@yandex.com.
Bülent
B
Altınsoy
Bulent Ecevit University, School of Medicine, Department of Radiology, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: iserif@yahoo.com.
Ismail
I
Serifoglu
Bulent Ecevit University, School of Medicine, Department of Cardiology, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: sayinmr@mynet.com.
Rasit
R
Sayın
Bulent Ecevit University, School of Medicine, Department of Biostatistics, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: cbuyukuysal@gmail.com.
Mustafa Cagatay
MC
Buyukuysal
Bulent Ecevit University, School of Medicine, Department of Pulmonology, Esenköy, Kozlu, Zonguldak 67600, Turkey. Electronic address: erboyfatma@gmail.com.
Fatma
F
Erboy
Saint Louis University, School of Medicine, Department of Radiology, St. Louis, Missouri 63110, United States. Electronic address: akdumane@slu.edu.
Ece Isin
EI
Akduman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
Adverse outcome; Computed tomography; Mortality; Pulmonary embolism; Right atrium