Diagnostic and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review
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Wiley
2025
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| author | Ankit Hanmandlu Aniruddh Mannari Aiden Abidov |
| author_facet | Ankit Hanmandlu Aniruddh Mannari Aiden Abidov Ankit Hanmandlu Aniruddh Mannari Aiden Abidov |
| collection | Wiley Open Access |
| contents | Diagnostic and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review Ankit Hanmandlu Aniruddh Mannari Aiden Abidov Echocardiography ABSTRACTBackgroundPulmonary embolism (PE) is a common cause of acute RV enlargement (often described as RV strain or RV‐S), with significant associated mortality and morbidity. Chest CT pulmonary angiography is a widely available diagnostic modality to rule out PE and assess for RV‐S, if positive for PE. Frequently, RV‐S is assessed by measuring the right ventricular (RV) to left ventricular (LV) ratio (RV/LV ratio); however, there is no standardized technique for measuring CT RV/LV ratio, and the prognostic value of this marker is not well‐defined.MethodsPubMed and EMBASE databases were searched from inception to December 2023. A total of 35 studies were eligible for data collection based on relevance, completeness, and quality of data.ResultsThe most common clinically effective cutoffs of the RV/LV ratio used were 0.9 and 1.0, and the most common methodology involved measuring RV and LV diameters within the same axial slice on both 2D (axial) and reconstructed 4‐Chamber (4‐Ch) views. Although 4‐Ch and axial views had different RV/LV ratio predictability regarding specific outcomes such as 30‐day death, there was no significant overall difference in the prognostic value across the different cutoffs used.ConclusionsOur study demonstrates a lack of definite standardization in measuring CT RV/LV ratio in acute PE. Based on our review, we propose an RV strain defined as CT RV/LV ratio >1.0 measured on a single axial CT slice as an easily measurable and reliable marker of RV dysfunction in acute PE, with associated significant prognostic value in predicting adverse outcomes. 10.1111/echo.70107 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/echo.70107 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_echo_70107 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Diagnostic and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review Ankit Hanmandlu Aniruddh Mannari Aiden Abidov Echocardiography Diagnostic and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review Ankit Hanmandlu Aniruddh Mannari Aiden Abidov Echocardiography ABSTRACTBackgroundPulmonary embolism (PE) is a common cause of acute RV enlargement (often described as RV strain or RV‐S), with significant associated mortality and morbidity. Chest CT pulmonary angiography is a widely available diagnostic modality to rule out PE and assess for RV‐S, if positive for PE. Frequently, RV‐S is assessed by measuring the right ventricular (RV) to left ventricular (LV) ratio (RV/LV ratio); however, there is no standardized technique for measuring CT RV/LV ratio, and the prognostic value of this marker is not well‐defined.MethodsPubMed and EMBASE databases were searched from inception to December 2023. A total of 35 studies were eligible for data collection based on relevance, completeness, and quality of data.ResultsThe most common clinically effective cutoffs of the RV/LV ratio used were 0.9 and 1.0, and the most common methodology involved measuring RV and LV diameters within the same axial slice on both 2D (axial) and reconstructed 4‐Chamber (4‐Ch) views. Although 4‐Ch and axial views had different RV/LV ratio predictability regarding specific outcomes such as 30‐day death, there was no significant overall difference in the prognostic value across the different cutoffs used.ConclusionsOur study demonstrates a lack of definite standardization in measuring CT RV/LV ratio in acute PE. Based on our review, we propose an RV strain defined as CT RV/LV ratio >1.0 measured on a single axial CT slice as an easily measurable and reliable marker of RV dysfunction in acute PE, with associated significant prognostic value in predicting adverse outcomes. 10.1111/echo.70107 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Diagnostic and Prognostic Value of RV Strain Defined as RV/LV Ratio on Chest CT in Acute Pulmonary Embolism: A Systematic Review |
| topic | Echocardiography |
| url | https://onlinelibrary.wiley.com/doi/10.1111/echo.70107 |