Figures
- Figure 1–
Forest plots for death within 3 months. Risk of death in patients with increased or normal right-to-left ventricle ratio. se: standard error; IV: inverse variance.
- Figure 2–
Forest plots for death at 30 days. Risk of death in patients with increased right-to-left ventricle ratio. CT-RVD +ve: computed tomography (CT)-detected right ventricle dysfunction (RVD) present; CT-RVD -ve: CT-detected RVD absent.
- Figure 3–
Forest plots for death at 30 days. Risk of death in patients with increased right-to-left ventricle ratio as assessed in transverse images. CT-RVD +ve: computed tomography (CT)-detected right ventricle dysfunction (RVD) present; CT-RVD -ve: CT-detected RVD absent.
- Figure 4–
Forest plots for death at 30 days. Risk of death in patients with increased right-to-left ventricle ratio as assessed in reconstructed images. CT-RVD +ve: computed tomography (CT)-detected right ventricle dysfunction (RVD) present; CT-RVD -ve: CT-detected RVD absent.
- Figure 5–
Forest plots for death at 30 days in haemodynamically stable patients. Risk of death in haemodynamically stable patients with increased right-to-left ventricle ratio. CT-RVD +ve: computed tomography (CT)-detected right ventricle dysfunction (RVD) present; CT-RVD -ve: CT-detected RVD absent.
Tables
- Table 1– Main features of studies reporting on the prognostic value of right ventricle dilation or dysfunction at computed tomography angiography
First author [ref.] Year Study design Included patients Age years Male Hypotension at admission Study outcome Follow-up duration Apfaltrer [19] 2012 Retrospective 60 65±14.4 47 (78) NA Death or adverse clinical events§ 2 months Araoz [20] 2003 Retrospective 173 60±17 106 (61) NA Death and adverse clinical events§ In hospital Araoz [21] 2007 Retrospective 1193 63±16 552 (46) 64+ Death 3 months Aviram [22] 2008 Retrospective 145 67±19 50 (35.5) NA All-cause mortality 1 month Baptista [23] 2013 Retrospective 39 59.1±19.6 18 (46.2) NA All-cause mortality 40 days, 33 months Bazeed [24] 2010 Retrospective 48 54±22 26 (54) NA All-cause mortality In hospital Becattini [11] 2011 Prospective 457 67±16.2 209 (45.7) 46 All-cause mortality or clinical deterioration§ In hospital Cai [25]# 2013 Retrospective 1596 M: 60.8±13.9
NM: 54.5±18.8M: 378 (45.3)
NM: 336 (44.2)NA All-cause mortality 1 month Ceylan [26] 2011 Retrospective 122 65±15 61 (50) NA All-cause mortality In hospital Díaz [27] 2007 Retrospective 89 60.2 (27–89) 35 (39) NA Death 3 months Furlan [28] 2012 Retrospective 635 58 (18–94) 304 (48) NA Death 1 month Ghaye [29] 2006 Retrospective 82 61±15 40 (49) 32+ All-cause mortality In hospital Gul [30] 2012 Prospective 61 62±17 23 (37.7) 0 Death 1 month Henzler [31] 2010 Retrospective 100 NA NA NA Death or adverse clinical events§ 1 month Jimenéz [32] 2013 Prospective 848 72 (59–80) 416 (49) 34 All-cause mortality 1 month Jeebun [33] 2010 Retrospective 137 65±16 (20–90) 57 (42) 41 Death In hospital Kang [34] 2011 Retrospective 260 55±18 139 (53.5) 0 All-cause mortality or adverse outcome§ 1 month Klok [35]¶ 2010 Prospective 113 56±17 60 (53) 0 Death or adverse clinical events§ 6 weeks Kumamaru [36, 37] 2012 Retrospective 200 60±16 87 (43.5) NA PE-related death or clinical deterioration§ 1 month Lu [38] 2008 Retrospective 50 60±13 (23–82) 19 (38) NA Death (all-cause and PE-related) 1 month Lu [39] 2012 Retrospective 674 58±17 302 (44.8) NA Death (all-cause and PE-related) 1 month Mansencal [40] 2005 Prospective 46 54±16 30 (65) 5 All-cause mortality 3 months Meyer [41] 2012 Prospective 83 Male: 61±13
Female: 64±1846 (55) 0 All-cause mortality and clinical deterioration 2 months Moroni [42] 2011 Retrospective 226 67±17 114 (50.4) 0 All-cause mortality 3 months Nural [43] 2009 Retrospective 53 61 (22–85) 26 (49) 20 All-cause mortality 1 month Ozsu [44] 2010 Prospective 108 70 (21–90) 61 (56) 0 All-cause mortality 1 month Ozsu [45] 2012 Retrospective 99 67±15 34 (34) 0 All-cause mortality 3 months Park [46] 2011 Retrospective 56 63.5 (52–71) 28 (50) 9 PE-related death or clinical deterioration§ 1 month Quiroz [10] 2004 Retrospective 63 58±15 27 (43) 13 Death or adverse clinical events§ 1 month Schoepf [47] 2004 Retrospective 431 59±16 192 (45) 27 All-cause mortality 1 month Soares [48] 2013 Retrospective 96 54±20 45 (47) 2 All-cause mortality 3 months Stein [49] 2008 Retrospective 157 57±17 65 (41) NA Death (all-cause and PE-related) In hospital van der Bijl [50]¶ 2011 Prospective 113 57±16 60 (53) 0 Death or adverse clinical events§ 6 weeks van der Meer [51] 2005 Retrospective 120 59±18 (18–89) 55 (46) 0 Death (all-cause and PE-related) 3 months Venkatesh [52] 2010 Retrospective 125 60 (16–94) 47 (38) NA PE-related death 1 month Zondag [53] 2013 Post hoc analysis 496 58±17 268 (54) 26 All-cause mortality 1 month Data are presented as n, mean±sd, mean (range), mean±sd (range) or n (%). M: malignancy; NM: no malignancy; NA: not available; PE: pulmonary embolism. #: data are reported separately for the two study groups; ¶: studies reporting on the same study population; +: systolic blood pressure defined as <100 mmHg; §: adverse clinical events usually included: cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy for systemic arterial hypotension, thrombolysis, catheter intervention, surgical embolectomy or subsequent admission to the intensive care unit.
- Table 2– Features of the scanners and assessment methods of right ventricle dilation or dysfunction
First author [ref.] CT Parameters for right ventricle dilation/dysfunction CT scanner Reconstructed image Right-to-left ventricle ratio Others Methods Cut-off Apfaltrer [19] 64 Both Transverse diameter
4-chamber diameters
VolumesNot reported Araoz [20] Single or 4 Both Transverse diameters
4-chamber diametersNot reported IVS bowing Araoz [21] Single, 4, 8, 16 No Transverse diameters Not reported IVS bowing Aviram [22] 10, 16, 40, 64 Yes 4-chamber diameters >0.9 RV short axis
IVC reflux
IVS bowingBaptista [23] 4, 64 No Transverse diameters >1 RV short axis
LV short axisBazeed [24] 64 Yes Transverse diameters >1 RV short axis Becattini [11] 4, 16 No Transverse diameters ≥0.9 Cai [25] 4, 16, 64 Yes 4-chamber diameters >1 Ceylan [26] 16 Both Transverse diameters
4-chamber diametersNot reported SVC diameter
IVS bowing
IVC refluxDíaz [27] 2 No Transverse diameters ≥1 Furlan [28] 16–64 Yes Transverse diameters ≥1 RV short axis
LV short axis
SVC diameter
IVC reflux
IVS bowingGhaye [29] Single Yes Transverse diameters >1 RV short axis
SVC diameter
IVC reflux
IVS bowingGul [30] 64 No Transverse diameters >1 PA diameter Henzler [31] 16, 64 Both Transverse diameters
4-chamber diameters
VolumesNot reported Jimenéz [32] NA No Transverse diameters >0.9 Jeebun [33] 4 No Transverse diameters Not reported Kang [34] 64 Both Transverse diameters
4-chamber diameters
Volumes>1
>1
>1.2IVS bowing
IVC refluxKlok [35]# Multi Yes Transverse diameters
4-chamber diameters>1 Kumamaru[36, 37] 16, 64 Both Transverse diameters
4-chamber diameters>0.9¶
>1Lu [38] 4–64 Yes 4-chamber diameters >1 Lu [39] 4, 16, 64 Both Transverse diameters
4-chamber diameters>0.9
>0.9Mansencal [40] 2 No Areas >1 Meyer [41] 16, 64 Yes Transverse diameters
4-chamber diameters
VolumesNot pre-specified Moroni [42] 4, 16 Yes Transverse diameters >1 IVS bowing
SVC diameterNural [43] Single or 16 No 4-chamber diameters Not reported RV diameter
SVC diameter
IVS bowing
IVC refluxOzsu [44] 4, 16 No Transverse diameters ≥1.1 Ozsu [45] 4, 16 No Transverse diameters ≥1.3 Park [46] 8 No Transverse diameters >1 IVS bowing Quiroz [10] 4 Both Transverse diameters
4-chamber diameters>0.9
>0.9Schoepf [47] 4, 16 Yes 4-chamber diameters >0.9 Soares [48] 64 Yes 4-chamber diameters ≥0.9 Stein [49] Multi No Transverse diameters >1 IVS bowing van der Bijl [50]# 16, 64 Both Transverse diameters
4-chamber diameters
Volumes>1
>1
>1.2RVEF van der Meer [51] Single No Transverse diameters >1 IVS bowing Venkatesh [52] 4 No Transverse diameters >0.9+ IVS bowing
RV diameterZondag [53] 4, 16, 64 No Transverse diameters >1 CT: computed tomography; IVS: inter-ventricular septum; RV: right ventricle; IVC: inferior vena cava; LV: left ventricle; SVC: superior vena cava; PA: pulmonary artery; RVEF: right ventricular ejection fraction; NA: not available. #: studies reporting on the same study population; ¶: data on the same study population have been reported in two publications; +: unpublished data.
Supplementary material
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Files in this Data Supplement:
- Supplementary material -
Right ventricle dysfunction: inter-ventricular septal bowing
Other parameters for right ventricle dysfunction at CT-angiography
Figures S1-S8
- Supplementary material -
Disclosures
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