Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

Perez, Amanda Arantes; Ribeiro, Antônio Luiz Pinho; Barros, Márcio Vinícius Lins; Sousa, Marcos Roberto de; Bittencourt, Roberto José; Machado, Fernando Santana; Rocha, Manoel Otávio Costa

doi:10.1590/s0066-782x2003000200009

Cited by 16 publications

(18 citation statements)

References 18 publications

(24 reference statements)

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“…2 Chest radiographs permit both a subjective appraisal of heart size as well as measurements of the cardiac silhouette which may, in turn, be related to the size of the thorax. 2,3 Studies have shown a satisfactory correlation (greater than 0.7) between the heart size measured on radiographs and that found at postmortem. 4 Chest radiography is the most commonly used modality for the detection of cardiomegaly and the cardiothoracic ratio has been used as an important indicator of cardiac size.…”

Section: Introductionmentioning

confidence: 85%

Establishing the cardiothoracic ratio using chest radiographs in an indigenous Ghanaian population: a simple tool for cardiomegaly screening

Mensah¹,

Mensah²,

Asiamah³

et al. 2015

Ghana Medical Journal

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SUMMARYBackground: Cardiothoracic ratio is a simple and cheap tool in the estimation of heart size. It is a useful index of cardiac size evaluation, and a value of 50% is generally considered to indicate the upper limit of normal. Study Objective: This study is to ascertain the normal mean value in cardiothoracic ratio of Ghanaians using chest radiography to serve as baseline for screening for cardiomegaly. Methodology: Standard postero-anterior radiographs of the -clients/patients were used in the study. The cardiothoracic ratio (CTR) was obtained by dividing the transverse cardiac diameter [sum of the horizontal distances from the right and left lateral-most margins of the heart to the midline (spinous processes of the vertebral bodies)] by the maximum internal thoracic diameter. Systematic sampling with appropriate inclusion and exclusion criteria were used to obtain a sample size of 1989. Results: The mean transverse cardiac diameter and cardiothoracic ratio increased with age. The transverse thoracic diameter increased with age until the sixth decade when it reduced with age. The mean CTR increased gradually with age with females having greater values than males. The mean CTR of the study population were 0.459, 0.467 and 0.452 for the general population, females and males respectively. Conclusion: This study has been able to establish 0.459 as the mean CTR values for Ghanaians. It has also shown the relationship between age and clients /patient's cardiothoracic ratio which compares favourably with findings of a similar study in Nigeria, a neighbouring country in the West African sub region with similar ethnic and social structure.

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Section: Introductionmentioning

confidence: 85%

Establishing the cardiothoracic ratio using chest radiographs in an indigenous Ghanaian population: a simple tool for cardiomegaly screening

Mensah¹,

Mensah²,

Asiamah³

et al. 2015

Ghana Medical Journal

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“…The degree of mitral regurgitation was also associated with PCS (p=0.003). BNP levels correlated with pulmonary Chest x-ray is an important exam in dilated cardiomyopathy, providing noninvasive information about heart dimension and pulmonary vessels at low costs 6 . To the best of our knowledge, the present study is the first to correlate parameters of pulmonary congestion by chest X-ray with ventricular dysfunction by Doppler echocardiogram in patients with Chagas cardiomiopathy.…”

Section: Ethicalmentioning

confidence: 99%

“…Chest x-ray is an important and inexpensive tool in the evaluation of patients with Chagas cardiomyopathy. An enlarged heart by this method indicates a poor prognosis 6 . However, pulmonary venous circulation by chest x-ray usually shows mild signs of pulmonary congestion, in spite of significant systolic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic parameters associated with pulmonary congestion in Chagas cardiomyopathy

Barral

Nunes

Barbosa

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction: Discrepancy between the intensity of pulmonary congestion and the grade of cardiomegaly seems to be a common finding of Chagas cardiomyopathy, in spite of significant systolic dysfunction of the left ventricle. Its mechanism has not been established. The aim of this study was to investigate pulmonary congestion and to analyze if it correlated with Doppler echocardiographic parameters in patients with Chagas dilated cardiomyopathy. Methods: Fifty-five patients with positive serology tests for Trypanosoma cruzi and Chagas dilated cardiomyopathy were studied. Chest x-rays, Doppler echocardiogram and plasmatic brain natriuretic peptide levels were obtained in all patients. The degree of pulmonary venous vessels changes on chest x-ray was graded using a pulmonary congestion score, and then compared to Doppler echocardiographic parameters. Results: Mean age was 48.5 ± 11.2 years and 29% were women. The majority (95%) of patients were in NYHA functional class I and II. Mild pulmonary congestion by chest x-ray was found in 80% of the patients. In a multivariate analysis, left ventricular ejection fraction, right ventricular TEI index and the color M-mode velocity correlated with the degree of pulmonary congestion. Conclusions: Pulmonary venous changes on chest x-rays are frequent, but usually mild in patients with Chagas dilated cardiomyopathy. The degree of pulmonary congestion correlates with Doppler echocardiographic left and right ventricular dysfunction and with color M-mode velocity.

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“…The finding of an enlarged heart by this method indicates a poor prognosis 5 . However, the intensity of pulmonary congestion is usually less than expected for the degree of cardiomegaly and of left ventricular (LV) systolic dysfunction 6 .…”

Section: Introductionmentioning

confidence: 97%

Echocardiographic parameters associated with pulmonary congestion in outpatients with Chagas' cardiomyopathy and non-chagasic cardiomyopathy

Barral

Nunes

Barbosa

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction: Despite significant left ventricular (LV) systolic dysfunction and cardiomegaly, pulmonary congestion does not seem to be a major finding in Chagas' cardiomyopathy (CC). This study sought to identify echocardiographic parameters associated with pulmonary congestion in CC and in dilated cardiomyopathy of other etiologies, such as non-CC (NCC), and to compare pulmonary venous hypertension between the two entities. Methods: A total of 130 consecutive patients with CC and NCC, with similar echocardiographic characteristics, were assessed using Doppler echocardiography and chest radiography. Pulmonary venous vessel abnormalities were graded using a previously described pulmonary congestion score, and this score was compared with Doppler echocardiographic parameters. Results: NCC patients were older than CC patients (62.4 ± 13.5 × 47.8 ± 11.2, p = 0.00), and there were more male subjects in the CC group (66.2% × 58.5%, p = 0.4). Pulmonary venous hypertension was present in 41 patients in the CC group (63.1%) and in 63 (96.9%) in the NCC group (p = 0.0), the mean lung congestion score being 3.2 ± 2.3 and 5.9 ± 2.6 (p = 0.0), respectively. On linear regression multivariate analysis, the E/e' ratio (β = 0.13; p = 0.0), LV diastolic diameter (β = 0.06; p = 0.06), left atrial diameter (β = 0.51; p = 0.08), and right ventricular (RV) end-diastolic diameter (β = 0.02; p = 0.48) were the variables that correlated with pulmonary congestion in both groups. Conclusions: Pulmonary congestion was less significant in patients with CC. The degree of LV of systolic and diastolic dysfunction and the RV diameter correlated with pulmonary congestion in both groups. The E/e' ratio was the hallmark of pulmonary congestion in both groups.

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Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

Abstract: Objective -To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients withChagas' disease. Methods

Cited by 16 publications

References 18 publications

Establishing the cardiothoracic ratio using chest radiographs in an indigenous Ghanaian population: a simple tool for cardiomegaly screening

Establishing the cardiothoracic ratio using chest radiographs in an indigenous Ghanaian population: a simple tool for cardiomegaly screening

Echocardiographic parameters associated with pulmonary congestion in Chagas cardiomyopathy

Echocardiographic parameters associated with pulmonary congestion in outpatients with Chagas' cardiomyopathy and non-chagasic cardiomyopathy

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