Evidence map›Paper›PMID 41174707›Full record

ArticleCritical care (London, England)2025

Ventricular septum curvature ratio: a novel imaging marker to predict clinical deterioration in normotensive acute pulmonary embolism.

Yizhuo Gao, Zhichun Gu, Xuejiao Wei, Shibo Wei, Yuchen Liu, Shanshan Zhan, Jing Yang, Chuanxin Qi, Shougang Qi, Minggang Wang and 1 more

Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05098769 (A Predictive Tool for Predicting Adverse Outcomes in Acute Pulmonary Embolism Patients Using Parameters Obtained by Computed Tomographic Pulmonary Angiography.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

NCT05098769 recruitingnot on this map

A Predictive Tool for Predicting Adverse Outcomes in Acute Pulmonary Embolism Patients Using Parameters Obtained by Computed Tomographic Pulmonary Angiography.

Typeobservational_patient_registrySponsorShengjing HospitalRan2021 to 2026Enrolled300ConditionsPulmonary Embolism and Thrombosis, Deterioration, Clinical
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

11 authors.

Yizhuo GaoDepartment of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Shenyang, China.
Zhichun GuDepartment of Pharmacy, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Xuejiao WeiDepartment of Public Health Sciences, Queen's University, Kingston, ON, Canada.
Shibo WeiDepartment of General Surgery, The Fourth Affiliated Hospital of China Medical University, No.4, Chongshan East Road, Shenyang, China.
Yuchen LiuDepartment of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Shanshan ZhanDepartment of Gerontology and Geriatrics, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, China.
Jing YangDepartment of Endocrinology, The Fourth Affiliated Hospital of China Medical University, No.4, Chongshan East Road, Shenyang, China.
Chuanxin QiDepartment of Emergency Medicine, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Shenyang, China.
Shougang QiDepartment of Emergency Medicine, The Third People's Hospital of Datong, No.1, Wenchang Street, Datong, China.
Minggang WangDepartment of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Dong JiaDepartment of Emergency Medicine, Shengjing Hospital of China Medical University, No.36, Sanhao Street, Shenyang, China. djia@cmu.edu.cn.

Funding

Applied Basic Research Plan Project of Liaoning Province 2023JH2/10600025Beijing Municipal Administration of Hospitals Incubating Program PG2023007Natural Science Foundation of Liaoning Province 2022-MS-186Natural Science Foundation of Liaoning Province 2022-MS-226Shenyang Science Technology Plan Project 22-321-33-16
6 · The paper itself

Abstract

backgroundIdentifying high-probability deterioration individuals at the time of admission remains a challenge in normotensive patients with acute pulmonary embolism (PE). Ventricular septum (VS) deviation, as observed on computed tomography pulmonary angiography (CTPA), has been associated with poor prognosis in acute PE patients. However, the quantitative relationship between the VS curvature ratio and clinical deterioration in normotensive acute PE patients has not been fully explored. This study aimed to investigate the role of the VS curvature ratio derived from CTPA as an image marker for deterioration in normotensive acute PE patients.

methodsThis prospective multicenter cohort study enrolled normotensive patients with acute PE across five centers in China between January 2021 and June 2024. The VS and left ventricle (LV) free-wall curvature radii were measured using CTPA, and the VS curvature ratio was calculated and categorized. The endpoint was the occurrence of clinical deterioration event within 30 days after admission. The relationship between the VS curvature ratio and deterioration was analyzed using hierarchical logistic regression. The efficacy of identifying deterioration was assessed using the area under the receiver operating characteristic curve (AUC).

resultsOf 3,310 patients, 272 (8.2%) experienced deterioration. In 3,030 patients from three centres, VS were categorized into four groups: VS bowing to the RV with its curvature ratio as < 1.60, 1.60-<1.90, ≥ 1.90, respectively; and the fourth group with VS straight or bowing to the LV. Using a VS curvature ratio < 1.60 as the reference, patients with higher VS curvature ratios had an increased risk of deterioration (odds ratio: 22.94 for ≥ 1.90 and 22.95 for VS straight & bowing to the LV, both p < 0.05). The VS curvature ratio demonstrated good discrimination for deterioration, with an AUC of 0.83 in the three local centers and 0.84 in the two non-local centers (280 patients).

conclusionsThe VS curvature ratio, derived from CTPA images, is a promising image marker for predicting deterioration in normotensive acute PE patients. This study highlights the potential clinical impact of VS curvature ratio to identify normotensive PE patients at increased risk of deterioration and to adjust management strategies accordingly. CLINICAL

trial registrationClinicalTrials.gov identifier: NCT05098769, October 16,2021, retrospectively registered.

Indexed as

Clinical DeteriorationPulmonary EmbolismVentricular SeptumAgedArea Under CurveChinaCohort StudiesComputed Tomography AngiographyFemaleHumansLogistic ModelsMaleMiddle AgedPrognosisProspective StudiesROC CurveClinical deteriorationComputed tomography pulmonary angiographyPulmonary embolismVentricular septum

Identifiers

PMID41174707
PMCPMC12577156

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Registered trials

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.