Cardiovascular diagnosis and therapy · 2026
Automated right ventricle-to-left ventricle diameter ratio predicts ICU stay for acute pulmonary embolism on CTPA examinations in the emergency department.
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Batra Kiran, Xi Yin, Anderson Kaj, Shah Trushil, Wiessman Maya, Govindu Saiabhiroop R, Vajramani Aashna, Peshock Ronald M
Аннотация
BACKGROUND: A reproducible and reliable automated tool to measure right ventricle-to-left ventricle diameter ratio (RV/LV) in acute pulmonary embolism (PE) examinations on computed tomography pulmonary angiography (CTPA) can suggest right ventricle (RV) enlargement, however the relationship to outcomes has not been investigated. The purpose of this study was to assess the relationship between an automated RV/LV ratio determined by an artificial intelligence (AI) algorithm, on a set of examinations deemed positive for acute PE by an AI algorithm on CTPA studies in the emergency department (ED) and various clinical parameters in predicting mortality and outcomes.
METHODS: This retrospective study included ED patients who underwent CTPA from April 2022 to October 2023. A commercial AI algorithm was applied to CTPA images with acute PE. Associations of automated RV/LV >1 in acute PE examinations with variables including interventional treatment, 30- and 90-day mortality, intensive care unit (ICU) admission and stay length were studied. Results were analyzed with a logistic regression model and reported as odds ratios (ORs).
RESULTS: In a cohort of 408 examinations from 408 patients, 142 examinations (35%) had an RV/LV ≤1 and 266 (65%) had an RV/LV >1. Patients with RV/LV >1 were more likely to be admitted into ICU ±12 hours of CTPA (25% vs. 15%, P=0.02) and more likely to undergo interventional radiology (IR) procedures (6.8% vs. 0.7%, P=0.006) compared to those RV/LV ≤1. The same group had higher odds of ICU admission both before and after adjusting for simplified pulmonary embolism severity index (sPESI) [unadjusted OR: 1.90 (1.12, 3.33), P=0.02; adjusted OR: 2.00 (1.14, 3.64), P=0.02].
CONCLUSIONS: Automated detected RV/LV >1 in acute PE examinations on CTPA in the ED has an association with ICU admission.
METHODS: This retrospective study included ED patients who underwent CTPA from April 2022 to October 2023. A commercial AI algorithm was applied to CTPA images with acute PE. Associations of automated RV/LV >1 in acute PE examinations with variables including interventional treatment, 30- and 90-day mortality, intensive care unit (ICU) admission and stay length were studied. Results were analyzed with a logistic regression model and reported as odds ratios (ORs).
RESULTS: In a cohort of 408 examinations from 408 patients, 142 examinations (35%) had an RV/LV ≤1 and 266 (65%) had an RV/LV >1. Patients with RV/LV >1 were more likely to be admitted into ICU ±12 hours of CTPA (25% vs. 15%, P=0.02) and more likely to undergo interventional radiology (IR) procedures (6.8% vs. 0.7%, P=0.006) compared to those RV/LV ≤1. The same group had higher odds of ICU admission both before and after adjusting for simplified pulmonary embolism severity index (sPESI) [unadjusted OR: 1.90 (1.12, 3.33), P=0.02; adjusted OR: 2.00 (1.14, 3.64), P=0.02].
CONCLUSIONS: Automated detected RV/LV >1 in acute PE examinations on CTPA in the ED has an association with ICU admission.