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

Hamid  Dahmardeh; Rahim  Momivand; Alireza  Vatankhah; Zahra  Hooshanginezhad; Mohamad Ghazanfari  Hashemi; Mohammad Kazem  Momeni; Hoseinali  Danesh

doi:10.18502/fbt.v11i4.16506

Hamid Dahmardeh Department of Radiology, Zahedan University of Medical Sciences, Zahedan, Iran
Rahim Momivand Oral and Maxillofacial Radiology Department, Hamadan University of Medical Sciences, Hamadan, Iran
Alireza Vatankhah Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranDepartment of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Zahra Hooshanginezhad Clinical Cardiologist, Department of Cardiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
Mohamad Ghazanfari Hashemi Department of Radiology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Kazem Momeni Department of Internal Medicine, School of Medicine, Clinical Immunology Research of Medicine, Ali IbneAbitaleb Hospital, Zahedan, Iran
Hoseinali Danesh Clinical Immunology Research Center, Department of Plastic, Reconstructive & Aesthetic Surgeon, Zahedan University of Medical Sciences, Zahedan, Iran

DOI: https://doi.org/10.18502/fbt.v11i4.16506

Keywords: Computed Tomography Pulmonary Angiography; Echocardiography; Pulmonary Thromboembolism; Heart Failure.

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.