title: Automatic assessment of cardiac load due to acute pulmonary embolism: Saddle vs. central and peripheral emboli distribution.
abstract: BACKGROUND
  Changes in cardiac chambers' volumes in relations to different distributions of pulmonary embolism (PE) have not been investigated.
  
  
  OBJECTIVE
  To compare cardiac chambers' volumes of patients with saddle, central or peripheral PE.
  
  
  METHODS
  Consecutive patients with PE on computed tomography pulmonary angiography (CTPA), 1/2007-12/2010, divided according to emboli distribution. Software automatically provided the volumes of each cardiac compartment. We measured the ability of each chamber's volume and ratios between the right and left ventricles (RV/LV) and right and left atria (RA/LA) to discriminate between emboli locations.
  
  
  RESULTS
  Among the 636 patients, 325 (51%) had peripheral, 278 (44%) central and 33 (5%) had saddle emboli. The RV/LV and RA/LA volume ratios discriminated well between saddle and central PE (AUC ≥0.74) and saddle and peripheral PE (AUC ≥0.83), but not between central and peripheral PE (AUC ≤0.6).
  
  
  CONCLUSIONS
  Automatic volumetric analysis of diagnostic CTPAs provides rapid tool which can discriminate between cardiac responses in saddle, central or peripheral PE.
authors.affiliation: Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: aviramgalit@hotmail.com.
authors.forename: Galit
authors.initials: G
authors.lastname: Aviram
authors.affiliation: Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eugene
authors.initials: E
authors.lastname: Soikher
authors.affiliation: Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Achiude
authors.initials: A
authors.lastname: Bendet
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tomer
authors.initials: T
authors.lastname: Ziv-Baran
authors.affiliation: Department of Internal Medicine 'D' and 'E', Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Hezzy
authors.initials: H
authors.lastname: Shmueli
authors.affiliation: Department of Internal Medicine 'D' and 'E', Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Limor
authors.initials: L
authors.lastname: Friedensohn
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Assi
authors.initials: A
authors.lastname: Milwidsky
authors.affiliation: Department of Radiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Sadovnik
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yan
authors.initials: Y
authors.lastname: Topilsky
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume / Q000502:physiology*; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000503:physiopathology
keywords: CT pulmonary angiography; Cardiac volumes; Pulmonary embolism; Risk stratification; Saddle embolus