The role of right ventricular volume in the diagnosis of pulmonary embolism and morbidity prediction




Right ventricular volume, Pulmonary embolism, Mortality


Background/Aim: Pulmonary embolism is a quite common and usually fatal disease. This study aimed to investigate the predictive value of the right ventricular volume in terms of pulmonary embolism and its laterality using imaging techniques. Methods: This case-control study included patients who underwent tomography with a pre-diagnosis of pulmonary embolism between January 2016 and January 2018. The study group included patients diagnosed with pulmonary embolism, while the control group consisted of those with an excluded diagnosis of embolism. The gender, age, echocardiography, right ventricular volume, embolism location, computed tomography results, morbidity, and mortality of the patients were recorded. Among 253 patients who underwent chest tomography with a diagnosis of pulmonary embolism, the data of 149 patients were obtained. There were 64 individuals in the control group and 85 individuals in the patient group. Results: In the study group, the length of hospital stay was 10.0 (range, 15.0-6.0) days, the systolic blood pressure was 125.5 (28.8) mmHg, the diastolic blood pressure was 77.8 (17.8) mmHg, and the heart rate was 103.4 (28.1) min. The ROC analysis of right ventricular volume revealed 81.2% sensitivity and 67.2% specificity (AUC: 0.850; P=0.001; 95% CI 0.789-0.910; cut-off: 103.7) in showing pulmonary embolism. There was a positive correlation between right ventricular volume and D-dimer (r: +0.739, P=0.001) in the control group and no correlation between the two in the study group (r: -0.178, P=0.139). Conclusion: Measuring the right ventricular volume with the software will contribute to the treatment and referral of patients with suspected pulmonary thromboembolism who underwent chest tomography. Thus, time and financial waste can be avoided by preventing unnecessary patient transfers, and early transfer of real patients can contribute to the reduction of mortality and morbidity.


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Laack TA, Goyal DG. Pulmonary embolism: an unsuspected killer. Emerg Med Clin North Am. 2004;22:961-83.

Pipavath SN, Godwin JD. Acute pulmonary thromboembolism: a historical perspective. AJR Am J Roentgenol. 2008;191:639-41.

White RH. The epidemiology of venous thromboembolism. Circulation. 2003;107(23-1):4-8.

Anderson FA, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med. 1991;151:933–8.

van Strijen MJ, de Monyé W, Kieft GJ, Pattynama PMT, Huisman MV, Smith SJ, et al. Diagnosis of pulmonary embolism with spiral CT as a second procedure following scintigraphy. Eur Radiol. 2003;13:1501-7.

Raja AS, Greenberg JO, Qaseem A, Denberg TD, Fitterman N, Schuur JD. Evaluation of patients with suspected acute pulmonary embolism: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2015;163:701-11.

Turkdogan FT, Ertekin E, Tuncyurek O, Dagli B, Canakci S, Ture M, et al. A new method: measurement of pancreas volume in computerised tomography as a diagnostic guide for acute pancreatitis. JPMA 2019; 70: 1408-12.

Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585-93.

Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital at autopsy. Chest. 1995;108:978–81.

Rubinstein I, Murray D, Hoffstein V. Fatal pulmonary embolism in hospitalized patients. Arch Intern Med. 1988;148:1425-6.

Tutar N, Ketencioğlu BB. Acute Right Ventricular Failure. Current Chest Diseases Series 2018; 6 (2):36-43.

McIntyre KM, Sasahara AA. The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. Am J Cardiol. 1971;28:288-94

McIntyre KM, Sasahara AA. The ratio of pulmonary arterial pressure to pulmonary vascular obstruction: index of preembolic cardiopulmonary status. Chest. 1977;71:692-7.

Pruszczyk P, Goliszek S, Lichodziejewska B, Kostrubiec M, Ciurzyński M, Kurnicka K, et al. Prognostic Value of Echocardiography in Normotensive Patients With Acute Pulmonary Embolism. JACC Cardiovasc Imaging. 2014;7(6):553-60.

Ates H, Ates I, Kundi H, Arikan MF, Yilmaz FM. A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index. Am J of Emerg Med. 201;35(10):1400-3.

Barco S, Mahmoudpour SH, Planquette B, Sanchez O, Konstantinides SV, Meyer G. Prognostic value of right ventricular dysfunction or elevated cardiac biomarkers in patients with low-risk pulmonary embolism: a systematic review and meta-analysis. European Heart J 2019; 40, (11): 902–10.

Yılmaz Z,Ercan G, Recep D. Affecting factors on early mortality in elderly patients diagnosed with pulmonary embolism in emergency department. Turkish J of Geriatrics: 2015;18(2):97-103.

Arseven O, Ekim N, Müsellim B, Oğuzülgen IK, Okumuş NG, Öngen G, et al. Pulmonary embolism diagnosis and treatment consensus report. Turkish Thorax J. 2015;1-85.

Sharif S, Eventov M, Kearon C, Parpia S, Li M, Jiang R, et al. Comparison of the age-adjusted and clinical probability-adjusted D-dimer to exclude pulmonary embolism in the emergency department. Am J of Emerg Med. 2018;37(5):845-50.

Doğan C, Cömert SS, Çağlayan B, Mutlu Ş, Fidan A, Kıral N. Retrospectıve Evaluatıon Of Pulmonary Thromboembolısm Cases. Izmir Chest Hosp J. 2016;30(1):15-21.

Duru S, Ergün R, Dilli A, Kaplan T, Kaplan B, Ardıç S. Clinical, laboratory and computed tomography pulmonary angiography results in pulmonary embolism: retrospective evaluation of 205 patients. Anatolian J of Card. 2012;12:142-9.

Sista, Akhilesh K. A pulmonary embolism response team’s initial 20 month experience treating 87 patients with submassive and massive pulmonary embolism. Vascular Med 2018;23(1): 65-71.

Zhang LJ, Zhao YE, Wu SY, Yeh BM, Zhou CS, Hu XB, et al. Pulmonary embolism detection with dual-energy CT: experimental study of dual-source CT in rabbits. Radiology. 2009;252:61–70.

Fink C, Johnson TR, Michaely HJ, Morhard D, Becker C, Reiser M, et al. Dual-energy CT angiography of the lung in patients with suspected pulmonary embolism: initial results. Rofo. 2008;180:879–83.

Lee CW, Seo JB, Song JW, Kim MY, Lee HY, Park YS, et al. Evaluation of computer-aided detection and dual energy software in detection of peripheral pulmonary embolism on dual-energy pulmonary CT angiography. Eur Radiol. 2011;21:54–62.

Pontana F, Faivre JB, Remy-Jardin M, Flohr T, Schmidt B, Tacelli N, et al. Lung perfusion with dual-energy multidetector-row CT (MDCT): feasibility for the evaluation of acute pulmonary embolism in 117 consecutive patients. Acad Radiol. 2008;15:1494–504.

Ateş H, Ateş İ, Kundi H, Yılmaz FM. Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism. J of Clin Lab Analy. 2017;31(5):22072.






Research Article

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Tunalı Türkdoğan F, Ertekin E, Zencir C, Yazici O, Tuncyurek O, Çanakçı SE. The role of right ventricular volume in the diagnosis of pulmonary embolism and morbidity prediction. J Surg Med [Internet]. 2021 Aug. 1 [cited 2022 Jun. 25];5(8):799-802. Available from: