Left ventricular mass and cardiothoracic index in patients with chronic renal disease on hemodialysis

Costa, Francisco de Assis; Póvoa, Rui Manuel dos Santos; Costa, André Falcão Pedrosa; Silva, Maria Alayde Mendonça da; Rivera, Ivan Romero; Ferro, Carlos; Filho, Alfredo Dias de Oliveira; Filho, Angelo Mario Bonfim de Sá; Lima, Valter Correia de

doi:10.5935/0101-2800.20140027

Cited by 4 publications

(5 citation statements)

References 8 publications

(4 reference statements)

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“…Although the CKD prevalence is higher in females, the decrease of GFR is more progressive in males [10,11]. In this study, the CKD prevalence is higher in our elderly subjects with age mean is 50,40 years old and like other similar studies, most patients diagnosed with CKD are in the age range of 50-59 years old [8,9]. Aging undergoes several changes in body that impact kidney function, so GFR declines with age [12].…”

Section: Discussionsupporting

confidence: 69%

“…Cardiomegaly can be detected using electrocardiogram (ECG), echocardiography, and chest x-ray (CXR). Although echocardiography is considered to be the gold standard for diagnosing cardiomegaly, its availability is still limited, expensive and requires trained experts [8,9]. The posteroanterior (PA) CXR is the most common imaging used as a reliable alternative as it is a widely available tool in medical facilities [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Chronic Kidney Disease with Cardiomegaly Imaging in Posteroanterior Chest X-ray

Amadita¹,

Priatna²,

Priyadi³

2021

Advances in Health Sciences Research

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Chronic kidney disease (CKD) is a health problem which prevalence is still high and one of the causes of cardiovascular complications. One of those cardiovascular complications is cardiomegaly. One way to identify cardiomegaly is by measuring the cardiothoracic ratio (CTR) in chest x-ray (CXR). The aim of this study is to see correlation, if any, of CKD and the cardiomegaly imaging in posteroanterior (PA) CXR. This was an observational analytic study with comparative crosssectional design. The total sample was 60 people who was divided into 2 groups, 30 people with CKD and 30 people without CKD who were taken by consecutive sampling technique. The data was analysed descriptively then followed by Chi-Square Test with 95% confidence interval. The results showed that 30 people (100%) were classified into stage 5 of CKD. Cardiomegaly was detected in 22 people (73.3%), the mean CTR was 60%, 22 people (73.3%) showed left ventricle enlargement, 20 people (66.7%) showed left atrium enlargement, and 7 people (23.3%) showed all chambers enlargement. There was a significant correlation between CKD and cardiomegaly (p=0.001 and PR=2.57).

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Correlation of Chronic Kidney Disease with Cardiomegaly Imaging in Posteroanterior Chest X-ray

Amadita¹,

Priatna²,

Priyadi³

2021

Advances in Health Sciences Research

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“…Comparing our research group with the group studied by Costa et al [ 22 ], in completely different populations (patients of cardiology clinics vs. patients with chronic kidney disease with hemodialysis introduced for at least six months), a similar percentage of patients with LVH was obtained (84.4% vs. 83.0%); however, the analysis of data on the distribution of certain types of geometry indicates the existing differences in the studied groups. Both were dominated by concentric overgrowth (the sum of CR and CH in our population is, i.e., 64.6% vs. 67.4% in the cited study), but the distribution of eccentric hypertrophy was slightly different (19.8% vs. 32.6%).…”

Section: Discussionsupporting

confidence: 64%

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

Truszkiewicz¹,

Macek

Poręba

et al. 2022

Radiology Research and Practice

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The aim of the study was to verify the usefulness of the radiological cardiothoracic ratio as a potential marker of left ventricular hypertrophy assessed by echocardiography. The study included 96 patients (mean age: 49.52 ± 9.64 years). Chest radiograph in the PA projection and echocardiography were performed. In CR the measurement of the cardiothoracic ratio (CTR) was performed. Assuming CTR > 0.50, heart silhouette enlargement was diagnosed. In echocardiography, four types of left ventricular geometry were assessed: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). It was shown that patients with an enlarged heart silhouette were characterized by a significantly more frequent occurrence of left ventricular hypertrophy (LVH) on echocardiography than patients with a nonenlarged heart silhouette. In the subgroup of patients with LVH compared to the subgroup of patients with normal left ventricular geometry, CTR values are statistically significantly higher, and heart silhouette enlargement is significantly more frequent. The criterion “CTR > 0.49” estimates LVH with a sensitivity of 93.3% and specificity of 82.7%, which translates into a high accuracy of 84.4%. By analyzing the prediction of left ventricular geometry types, high accuracy of CH prediction was obtained using the “CTR > 0.49” criterion of 80.2% (with a high sensitivity of 84.0% and a satisfactory specificity of 60.0%) and a high accuracy of EH prediction using the “CTR > 0.52” criterion of 71.9% (with high sensitivity 80.5% and low specificity 36.8%), as well as low CR prediction accuracy of only 57.3% (with low sensitivity 36.7%, even if high specificity 78.7%). In summary, the radiological cardiothoracic ratio may be a moderate marker of left ventricular hypertrophy assessed according to standard echocardiographic criteria, provided that its cut-off point is standardized in each population of subjects.

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“…According to our knowledge, this is the first study to build a scoring system by combining various clinical risk factors of LVH, CTR in chest X-ray, and SLVA in ECG. Although there have been studies to modify diagnostic accuracy of ECG, none had presented a scoring system including clinically significant parameters [16, 17]. With utilization of the well-known clinical risk factors, traditional ECG diagnostic criteria of LVH and CTR≥0.50, we could build a relatively clear-cut and easy-to-use model to screen LVH far better than the traditional ECG criteria [31].…”

Section: Discussionmentioning

confidence: 99%

“…It is the most widely known chest radiograph index of cardiac function. Enlarged CTR, defined as >0.50, has been evaluated in patients with chronic kidney disease under hemodialysis and has shown prognostic significance [16, 17]. Both CTR and ECG can be easily obtained quickly and without use of contrast agent and potentially can be used as initial screening methods for large number of subjects [18, 19].…”

Section: Introductionmentioning

confidence: 99%

A Fortified Method to Screen and Detect Left Ventricular Hypertrophy in Asymptomatic Hypertensive Adults: A Korean Retrospective, Cross-Sectional Study

Park

Chon

et al. 2018

International Journal of Hypertension

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Purpose Left ventricular (LV) mass is determined by the wall thickness and diameter. LV hypertrophy (LVH), the increase in LV mass, is usually screened with electrocardiography but is often insensitive. We tried to fortify the rule to detect LVH using cardiothoracic ratio (CTR) in chest X-ray and well-known risk factors besides electrocardiography. Materials and Methods This retrospective cross-sectional study included asymptomatic hypertensive individuals aged ≥40 y who underwent voluntary checkups including echocardiography. Independent variables to explain LVH (LV mass index>115 g/m2 for men and >95 g/m2 for women calculated on echocardiography) were chosen among Sokolow-Lyon voltage amplitude (SLVA), CTR and cardiovascular risk factors by multiple logistic regression analysis. The diagnostic rule to detect LVH was made by summing up the rounded-off odds ratio of each independent variable and was validated using bootstrapping method. Results Among the 789 cases enrolled (202 females (25.6%), mean age 59.6±8.8 y), 168 (21.3%) had LVH. The diagnostic rule summed female, age≥65 y, BMI≥25 kg/m2, SLVA≥35 mm, and CTR≥0.50 (scoring 1 per each). Its c-statistics was 0.700 (95% CI: 0.653, 0.747), significantly higher (p<0.001) than that of SLVA≥35 mm, 0.522 (95% CI: 0.472, 0.572). The sensitivity and specificity of the model were 61.9% and 72.1% for score≥2 and 30.4% and 92.9% for score≥3. The SLVA≥35 mm criteria showed sensitivity of 12.5% and specificity of 91.9%. Conclusions The rule to sum up the number of the risk factors of female, age≥65 y, BMI≥25 kg/m2, SLVA≥35 mm, and CTR≥0.50 may be a better diagnostic tool for screening LVH, than the electrocardiography-only criteria, at the score≥2.

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Left ventricular mass and cardiothoracic index in patients with chronic renal disease on hemodialysis

Abstract: Chest radiography is a safe and useful as a diagnostic tool of LVH in CKD patients on HD.

Cited by 4 publications

References 8 publications

Correlation of Chronic Kidney Disease with Cardiomegaly Imaging in Posteroanterior Chest X-ray

Correlation of Chronic Kidney Disease with Cardiomegaly Imaging in Posteroanterior Chest X-ray

Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography

A Fortified Method to Screen and Detect Left Ventricular Hypertrophy in Asymptomatic Hypertensive Adults: A Korean Retrospective, Cross-Sectional Study

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