The current analysis suggests that patients with a smaller LA volume, by nongated CTPA, have a higher risk of mortality after PE. Given the known heterogeneity of LA volumes according to body surface area (BSA), it would be helpful to index LA volumes to BSA. Studies have demonstrated that LA size was larger with increasing body size and male sex, potentially explaining up to 29% of LA size variability. Additionally, race should be taken into account because of the significantly greater dimensions among whites, as well as evident racial disparities with PE mortality. To partially account for patient BSA, right atrial to LA ratio was used by Chow et al to predict long-term mortality; however, this association was not as definitive. The CTPA images are nongated and represent data from a range of cardiac phases, with reduced filling time at higher heart rates. This may partly account for why the right atrial to LA volume ratio association is not as strong by CTPA. The increasing availability of advanced CT scanner systems will enable excellent-quality gated PE examinations, making metrics derived from chamber volumes more reliable.