Chest radiograph in the diagnosis of left ventricular dysfunction

Redistribution and cardiomegaly may be the best chest radiographic findings for diagnosing increased preload and reduced ejection fraction, respectively, but they have only moderate sensitivities and specificities.

A systematic review including 29 studies with a total of 4 692 subjects was abstracted in DARE. Of these 16 had the chest radiograph reading blinded to the standard criterion result. The gold standard was echocardiography, radionuclide ventriculograph or invasive pressure measurement. Redistribution best diagnosed increased pre-load with a sensitivity of 65% (95% CI 55% to 75%) and a specificity of 67% (95% CI 53% to 79%). Cardiomegaly best diagnosed decreased ejection fraction with a sensitivity of 51% (95% CI 43% to 60%) and specificity of 79% (95% CI 71% to 85%).

Comment: The large number of unblinded studies may have influenced the results.

Ədəbiyyat

1. Badgett RG, Mulrow CD, Otto PM, Ramírez G. How well can the chest radiograph diagnose left ventricular dysfunction? J Gen Intern Med 1996 Oct;11(10):625-34.