A new electrocardiographic parameter terminal D1S + D3R predicts right ventricular dilatation in acute pulmonary embolism

Right ventricular (RV) overload findings affect the risk classification and treatment approach in acute pulmonary embolism (APE). Recently, it was reported that a new electrocardiography (ECG) parameter, terminal D1S + D3R (T-D1S + D3R) pattern, supported the diagnosis of APE. We aim to search the relationship between T-D1S + D3R pattern and right ventricular dilatation (RVD) in APE. This single-centre, retrospective study was designed with patients aged &gt; 18 years. We screened 267 patients who underwent transthoracic echocardiography (TTE) because of confirmed APE in our emergency department. This study included 72 patients with RVD and 139 patients without RVD [male 41.7%, median age 73,0 (20.8) years; 49.6% male, median age 64,0 (24.0) years]. We compared T-D1S + D3R between RVD (+) and RVD (-) groups. We determined that RVD (+) group had more patients with the T-D1S + D3R parameter than RVD (-) group [51 (70.8%) vs. 25 (18.0%), <i>p</i> &lt; 0.001]. In the univariate logistic regression analyses S1Q3T3, (in)complete right bundle branch block (RBBB), T-D1S + D3R, D3-V1 T wave inversion (TWI), V1-3/4 TWI, V1-3/4 ST-segment elevation, and frontal QRS-T [f(QRS-T)] angle predicted RVD, while T-D1S + D3R, V1-3/4 ST-segment elevation, and f(QRS-T) angle remained independent predictors of RVD in patients with APE. T-D1S + D3R, a new ECG parameter, was an independent predictor of RVD in patients with APE.