Role of right/left ventricular diameter ratio in therapy selection for high and low intermediate‑risk pulmonary embolism in the Emergency Department

Karakaya,Emir; Sönmez,Bedriye Müge; Cigsar,Gülsen; Sirin,Ilker; Süer Dogan,Ihsaniye

doi:10.3892/etm.2025.12823

Role of right/left ventricular diameter ratio in therapy selection for high and low intermediate‑risk pulmonary embolism in the Emergency Department

Authors:
- Emir Karakaya
- Bedriye Müge Sönmez
- Gülsen Cigsar
- Ilker Sirin
- Ihsaniye Süer Dogan
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Affiliations: Department of Emergency Medicine, University of Health Sciences Dışkapı Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, 06110 Ankara, Turkey, Department of Radiology, University of Health Sciences Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, 06110 Ankara, Turkey
Published online on: February 12, 2025 https://doi.org/10.3892/etm.2025.12823
Article Number: 73

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Abstract

Patients with intermediate‑risk pulmonary embolism (PE) comprise a significant patient population. Computerized tomographic pulmonary angiography (CTPA) plays a crucial role in diagnosis and determining the prognosis. Right ventricular diameter/left ventricular diameter (RVD/LVD) ratio measured through CTPA provides insight into right ventricular overload. The aim of the present study was to determine the role of RVD/LVD ratio on decision of treatment between high and low intermediate‑risk PE. A retrospective observational study was conducted between May 2018 and May 2022 on patients with intermediate‑risk PE at the Emergency Department (ED) of a tertiary care hospital. The demographic information, risk factors, vital signs at presentation, laboratory data, CTPA images and treatment modality of the patients were obtained. RVD/LVD was calculated from the CTPA images. All‑cause mortality at 24 h, 7 and 30 days were recorded. A total of 127 patients were included. In total, 52 (40.9%) patients were in the low‑intermediate risk group, and 75 (59.1%) patients were in the intermediate‑high risk group. A total of 54 patients were administered thrombolytic therapy while 73 patients were not. The mean RVD/LVD was 1.35±0.25 in patients who were administered thrombolytic therapy and 1.17±0.34 in those who were not. A significant association was identified between RVD/LVD and the administration of thrombolytic therapy (P<0.001). RVD/LVD and mortality were not significantly correlated (P=0.248). No significant association was found between the administration of thrombolytic therapy and mortality (P=0.569). RVD/LVD assessed through CTPA was found to be significantly decisive for administering thrombolytic therapy but not significantly predictive for mortality in intermediate‑risk patients with PE presenting to the ED.

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