Evidence map›Paper›PMID 31838650›Full record

ArticleJournal of thrombosis and thrombolysis2020

Performance of the right ventricular outflow tract/aortic diameter as a novel predictor of risk in patients with acute pulmonary embolism.

Alexandru Marginean, Andrew Putnam, Taishi Hirai, Anthony Serritella, Stephanie A Besser, Margaret Lee, Janet Friant, John Blair, Atman Shah, Sandeep Nathan and 2 more

Abstract read
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In one paragraph

Article in Journal of thrombosis and thrombolysis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Alexandru MargineanDepartment of Medicine, University of Chicago, Chicago, IL, USA. a.t.marginean@gmail.com.ORCID http://orcid.org/0000-0003-1482-226X
Andrew PutnamDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Taishi HiraiDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Anthony SerritellaDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Stephanie A BesserDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Margaret LeeDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Janet FriantDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
John BlairDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Atman ShahDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Sandeep NathanDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
Jonathan ChungDepartment of Radiology, University of Chicago, Chicago, IL, USA.
Jonathan PaulDivision of Cardiology, Department of Medicine, University of Chicago, Chicago, IL, USA.
University of Chicago · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Right ventricular (RV) enlargement, determined via the ratio of the right to left ventricular diameters (RV/LV) by CT imaging is used to classify the severity of acute pulmonary embolism (PE) and impacts treatment decisions. The RV/LV ratio may be an unreliable marker of RV dysfunction, due in part to the complex RV geometry. This study compared the RV/LV ratio to a novel metric, the ratio of the right ventricular to aortic outflow tract diameters (RVOT/Ao) in patients with acute PE treated with catheter-directed therapies (CDT). RVOT/Ao and RV/LV ratios were measured on CT images from 103 patients who received CDT for acute submassive or massive PE and were compared to RV dysfunction severity determined by transthoracic echocardiography. Ratios and biomarkers on admission were assessed for correlation with invasively-measured hemodynamics [right atrial (RA) pressure, mean pulmonary artery (PA) pressure, cardiac output (CO)]. RVOT/Ao but not RV/LV ratios were increased in patients with moderate or severe RV dysfunction compared to those without RV dysfunction (p < 0.05). Neither ratio showed significant correlation with RA (r = 0.09 vs 0.055, p > 0.05), mean PA pressure (r = 0.167 vs 0.146, p > 0.05), or CO (r = 0.021 vs - 0.183, p > 0.05). proBNP correlated with mean PA pressure (r = 0.377, p < 0.05). The RVOT/Ao ratio may be better at assessing RV dysfunction than the RV/LV ratio in patients presenting with acute PE. Although currently accepted protocols rely on the RV/LV ratio in determining when CDT are of benefit, the RVOT/Ao ratio may be a more useful tool in identifying high risk patients.

Indexed as

AortaHeart VentriclesPulmonary EmbolismCardiac OutputComputed Tomography AngiographyEchocardiographyFemaleHumansMaleMiddle AgedOdds RatioOrgan SizePatient SelectionPrognosisPulmonary ValveRisk AssessmentComputed tomographyMassivePulmonary embolismRiskSubmassive

Identifiers

PMID31838650
OpenAlexW2996634116

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.