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Original research article

Routine Chest X-ray: Still Valuable for the Assessment of Left Ventricular Size and Function in the Era of Super Machines

Maria-Aurora MoralesRenato PredilettoGiuseppe RossiGiosuè CatapanoMassimo LombardiDaniele Rovai
CNR, Clinical Physiology Institute, 1G Monasterio Foundation, Pisa, Italy
Date of Submission: 10-Jan-2012, Date of Acceptance: 06-Apr-2012, Date of Web Publication: 23-May-2012.
Corresponding Author:
Corresponding Author

Maria‑Aurora Morales

E-mail: morales@ifc.cnr.it

Corresponding Author:
Corresponding Author

Maria‑Aurora Morales

E-mail: morales@ifc.cnr.it

DOI: 10.4103/2156-7514.96540 Facebook Twitter Google Linkedin


Objectives: The development of technologically advanced, expensive techniques has progressively reduced the value of chest X-ray in clinical practice for the assessment of left ventricular (LV) dilatation and dysfunction. Although controversial data are reported on the role of this widely available technique in cardiac assessment, it is known that the cardio-thoracic ratio is predictive of risk of progression in the NYHA Class, hospitalization, and outcome in patients with LV dysfunction. This study aimed to evaluate the reliability of the transverse diameter of heart shadow [TDH] by chest X-ray for detecting LV dilatation and dysfunction as compared to Magnetic Resonance Imaging (MRI) performed for different clinical reasons.
Materials and Methods: In 101 patients, TDH was measured in digital chest X-ray and LV volumes and ejection fraction (EF) by MRI, both exams performed within 2 days.
Results: A direct correlation between TDH and end-diastolic volumes (r = .75, P<0.0001) was reported. TDH cut-off values of 14.5 mm in females identified LV end-diastolic volumes >150 mL (sensitivity: 82%, specificity: 69%); in males a cut-off value of 15.5 mm identified LV end-diastolic volumes >210 mL (sensitivity: 84%; specificity: 72%). A negative relation was found between TDH and LVEF (r = -.54, P<0.0001). The above cut-off values of TDH discriminated patients with LV systolic dysfunction – LVEF <35% (sensitivity and specificity: 67% and 57% in females; 76% and 59% in males, respectively).
Conclusions: Chest X-ray may still be considered a reliable technique in predicting LV dilatation by the accurate measurement of TDH as compared to cardiac MRI. Technologically advanced, expensive, and less available imaging techniques should be performed on the basis of sound clinical requests.
Keywords: Cardiac MRI, Chest X-ray, Left Ventricular Dilatation, Left Ventricular Dysfunction

Cited in 3 Documents

  1. Iwona Grabowska, Neha Sharma, Alina Vasilescu, Madalina Iancu, Gabriela Badea, Rabah Boukherroub, Satishchandra Ogale and Sabine Szunerits (2018) Electrochemical Aptamer-Based Biosensors for the Detection of Cardiac Biomarkers. ACS Omega 3(9):12010. doi: 10.1021/acsomega.8b01558
  2. Jyotindu Debnath, C.M. Sreedhar, Ruchira Mukherjee, V.K. Maurya, Seema Patrikar and Y.R.N. Reddy (2018) Revisiting anatomical variants on screening chest radiographs in Indian adolescents: A cross sectional observational pilot study. Medical Journal Armed Forces India 74(4):337. doi: 10.1016/j.mjafi.2017.07.010
  3. Hanif Esmail, Tolu Oni, Friedrich Thienemann, Nashreen Omar-Davies, Robert J. Wilkinson, Mpiko Ntsekhe and Chiara Lazzeri (2016) Cardio-Thoracic Ratio Is Stable, Reproducible and Has Potential as a Screening Tool for HIV-1 Related Cardiac Disorders in Resource Poor Settings. PLoS ONE 11(10):e0163490. doi: 10.1371/journal.pone.0163490

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