Right Ventricular Enlargement on Chest Computed Tomography

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Abstract
Background— We investigated the prognostic role of right ventricular enlargement on multidetector-row chest CT in acute pulmonary embolism (PE). Methods and Results— We studied 63 patients with CT-confirmed PE who underwent echocardiography within the ensuing 24 hours. Adverse clinical events, defined as 30-day mortality or the need for cardiopulmonary resuscitation, mechanical ventilation, pressors, rescue thrombolysis, or surgical embolectomy, were present in 24 patients. We performed off-line CT measurements of right and left ventricular dimensions (RVD, LVD) with axial and 2-dimensional reconstructed 4-chamber (4-CH) views. The proportion of patients with RVD/LVD>0.9 on the axial view was similar in patients with (70.8%) and those without adverse events (71.8%; P=0.577). In contrast, RVD/LVD>0.9 on the 4-CH view was more common in patients with (80.3%) than without (51.3%; P=0.015) adverse events. The area under the curve of RVD/LVD from the axial and 4-CH views for predicting adverse events was 0.667...