The effects of left ventricular function on right heart in the patients with acute pulmonary embolism

The optimal treatment approach of haemodynamically stable patients with acute pulmonary embolism (PE) remains controversial. Absence of RV dilatation or the ratio of RVD/LVD (<0.9) identifies patients at low risk of all-cause mortality in acute PE. Normally, we know that both ventricles' motion and wall thickness may affect each other. In this study, we aimed to evaluate the effect of left ventricular functions on the findings of right ventricular dysfunction in the patients with acute PE. The present study was a retrospective cross- sectional design. The patients were firstly categorized according to early mortality risk stratification. Later, intermediate-high and high risk groups were re-categorized according to having or not having left ventricular dysfunction by echocardiography. The cardiac findings and measurements were obtained from both thorax computerized tomography angiography and echocardiography. A total of 200 patients with acute PE were included in the study. The ratio of RVD/LVD was found significantly higher in patients with normal LV function than the patients with LV dysfunction (p:0.030). But, the RV and LV wall thickness, D-septum were similar among the patient groups (p>0.05). The ratio of RVD/LVD was found significantly higher in patients with normal LV function and acute PE. We think that baseline LV function may affect the findings of RV during acute PE event. Especially when we evaluate intermediate-high risk patients by echocardiography, we should consider left ventricular function.