Association between cardiothoracic ratio, left ventricular size and systolic function in patients undergoing computed tomography coronary angiography

Abstract

The present study aimed to investigate the association between cardiothoracic ratio (CTR) and left ventricular (LV) systolic function parameters in patients with or without preserved LV ejection fraction (LVEF). A total of 203 subjects suspected with coronary artery disease underwent chest radiography and dual source computed tomography coronary angiography (DSCT-CA). The LV systolic function parameters: LV end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), and LVEF were measured from the DSCT-CA. The association between CTR and LV systolic function parameters was analyzed according to LVEF value (<55%, depressed LVEF group; versus ≥55%, preserved LVEF group) and CTR value (<0.5, normal range CTR group; versus ≥0.5, larger CTR group). The LVEDVI and LVESVI were higher in the depressed LVEF group compared with the preserved LVEF group (108.56±57.15 vs. 67.52±14.56 ml/m2, P<0.001; and 64.07±37.81 vs. 20.23±7.23 ml/m2, P<0.001, respectively) and lower in the normal range CTR group compared with the larger CTR group (67.10±15.00 vs. 77.30±34.32 ml/m2, P=0.009 and 21.94±8.96 vs. 28.97±26.54 ml/m2, P=0.017, respectively). Significant correlations were found between CTR and LVEDVI, and LVESVI and LVEF in the depressed LVEF group (r=0.66, P<0.001; r=0.65, P<0.001; and r=−0.46, P=0.018, respectively). However, there was no significant association detected between CTR and LV systolic function parameters in the other subgroups. The LVEDVI and LVESVI showed an inverse correlation with the LVEF in each group. Although the CTR was not a reliable indicator of LV size and systolic function in patients with preserved LVEF, it was correlated with LV size and LVEF in patients with depressed LVEF.

Ejection fraction as related to basic components in the left and right ventricular volume domains

“…However, further progress was hampered by the fact that no statistical tool was available to compare the analytically derived nonlinear regression lines. Without any attempt for justification of a particular choice regarding the regression model, most studies persisted in using the linear approach for the full clinically relevant spectrum [7][8][9][10][11]. Three major shortcomings of the linear approximation refer to the fact that (i) the theoretical point where EF reaches 100% for small ESVi values is not respected; (ii) the asymptotic range at lower EF values is not adequately incorporated; (iii) thus far the intrinsic nonlinearity of the intermediate range is insufficiently acknowledged.…”

Correlation between Heart Failure with N-Terminal-Pro-B Type Natriuretic Peptide and Cardiothoracic Ratio from Chest Radiograph in Pediatric Heart Disease

“…20 The diagnostic accuracy from CT ratio for evaluation of function both LV and RV from many studies showed low accuracy. [21][22] In LV systolic function showed no significant association with CT ratio in patients with preserved left ventricular ejection fraction who had undergone computed tomography coronary angiography. But the CT ratio correlated with LV size and LV ejection fraction (LVEF) in patients with depressed LVEF.…”

“…But the CT ratio correlated with LV size and LV ejection fraction (LVEF) in patients with depressed LVEF. 21 In another study, The CT ratio reflected atrial dilatation rather than ventricular dilatation. 22 Our study showed a significant positive correlation of CT ratio with symptomatic heart failure in pediatric heart disease.…”

Utility of Recipient Cardiothoracic Ratio in Predicting Delayed Chest Closure after Heart Transplantation

“…In the chronic heart failure population, it can be used for risk stratification with values >0.5 associated with poor prognosis 20 . Additionally, in patients with reduced ejection fraction (EF), CTR has shown some correlation with left ventricular volume index and systolic dysfunction 21 . In the pediatric population, an increased CTR is associated with increased total cardiac volume in the setting of valvular insufficiency 22 .…”