The value of the chest X-Ray for diagnosing left ventricular dysfunction

الملخص EN

Background : The use of the chest x-ray measurements which includes the cardiothoracic ratio(C-T) and frontal area (FA) of the heart by the CXR are useful measures for primary assessment of the cardiac dysfunction. Patients and Methods : A Prospective study was done from the 1st of January 2005 to the 1st of October in the same year on a 120 consecutive patients who have been admitted for coronary and L.V angiogram at IBN-AL-BITAR hospital.

The C-T ratio and the frontal area were measured. Results : The study comprised 120 subjects who were admitted for coronary and L.V angiogram for diagnostic reasons.

89subjects (74.2 %) are male and 31subjects (25.8 %) are female .17 (14 %) subjects have left ventricular dysfunction and dilated L.V with EDV ≥ 110 cm^2 by angiogram.

(76) Subjects (71 %) had LAD (Left anterior descending artery disease), (40) subjects (37 %) had LCX (Left circumflex artery disease), 10subjects (9 %) had LMS (Left main stem artery disease) and (38) subjects (34 %) RCA (disease).

13subjects (10 %) had valve disease, 2subjects (1 %) of them have aortic stenosis , 5 subjects (4 %) had A.

I (aortic inche), 4 subjects (3 %) had M.

S (Mitral stenosis), 6 subjects (5 %) had M.

R Mitral regurgitation and combined valve disease .The abnormal chest radiogram C / T Ratio had a sensitivity of 56.6 %, a specificity of 78.6 %, and positive, negative predictive values and accuracy of 95.2 %, 19.3 % and 59.2 % respectively, in the diagnosis of left ventricular dysfunction.

while the abnormal chest radiogram FA / BSA £ had a sensitivity of 47.2 %, specificity of 42.9 %, and positive, negative predictive values and accuracy of 86.2 %, 9.7 % and 46.7 % respectively. Conclusion : The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction ; its use as a screening method to initially approach the patient with ventricular dysfunction should be reevaluated.