ArticleJournal of cardiothoracic surgery2026
Evaluating inferior vena cava reflux and RV/LV ratio as predictors of acute pulmonary thromboembolism severity.
Article in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study aimed to evaluate the predictive value of inferior vena cava (IVC) reflux and the right ventricle to left ventricle ratio (RV/LV ratio) in risk stratification of acute pulmonary thromboembolism (APTE) patients.
methodsIn this retrospective, cross-sectional study, eighty-six patients diagnosed with APTE underwent computed tomography pulmonary angiography (CTPA). The pulmonary arterial obstruction index (Qanadli score) was evaluated by an experienced radiologist, along with the RV/LV ratio and IVC reflux grading (1-6) based on CTPA. Correlations between the Qanadli score, IVC reflux grade, and RV/LV ratio were analyzed. Linear regression was performed after confirming regression assumptions. Additionally, IVC reflux grade and Qanadli score were compared between patients with RV/LV ratios below and above 0.9.
resultsThe mean Qanadli score was 7.20 ± 8.04. A significant correlation was found between the Qanadli score and IVC reflux grade (r = 0.601, p < 0.001), whereas no significant correlation was observed between the Qanadli score and RV/LV ratio (r = 0.131, p = 0.230). Further analysis demonstrated a significant linear association between the Qanadli score and IVC reflux grade, with a regression coefficient of 3.98 ± 0.55 (p < 0.001) and an adjusted R² of 0.38. However, patients with an RV/LV ratio > 0.9 did not show a significant difference in IVC reflux grade (p = 0.176) or Qanadli score (p = 0.439).
conclusionOur study highlights IVC reflux as a potential valuable imaging marker for assessing APTE severity, while also pointing out the limitations of relying solely on the RV/LV ratio for risk stratification.
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