ArticleHeart (British Cardiac Society)2007
Cardiothoracic ratio within the "normal" range independently predicts mortality in patients undergoing coronary angiography.
Article in Heart (British Cardiac Society), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Association between the Cardiothoracic Ratio on Chest X-rays and the Respiratory Function in Patients with Interstitial Lung Diseases: a Cross-sectional Study.Internal medicine (Tokyo, Japan) · 2025Article
- Deep learning to predict long-term mortality from plain chest X-ray in patients referred for suspected coronary artery disease.Journal of thoracic disease · 2024Article
- An Efficient, Lightweight, Tiny 2D-CNN Ensemble Model to Detect Cardiomegaly in Heart CT Images.Journal of personalized medicine · 2023Article
- Association between D-dimer and long-term mortality in patients with acute severe hypertension visiting the emergency department.Clinical hypertension · 2023Article
- A study on computed tomography cardiothoracic ratio in predicting left ventricular systolic dysfunction.Clinical and experimental emergency medicine · 2023Article
- Cardiothoracic ratio values and trajectories are associated with risk of requiring dialysis and mortality in chronic kidney disease.Communications medicine · 2023Article
- Association of Dipstick Proteinuria with Long-Term Mortality among Patients with Hypertensive Crisis in the Emergency Department.Journal of personalized medicine · 2022Article
- Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography.Radiology research and practice · 2022Article
- Diagnostic performance of chest radiography measurements for the assessment of cardiac chamber enlargement.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Limitations of cardiothoracic ratio derived from chest radiographs to predict real heart size: comparison with magnetic resonance imaging.Insights into imaging · 2021Article
- Radiologists can visually predict mortality risk based on the gestalt of chest radiographs comparable to a deep learning network.Scientific reports · 2021Article
- Small whole heart volume predicts cardiovascular events in patients with stable chest pain: insights from the PROMISE trial.European radiology · 2021Article
- Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard.International journal of environmental research and public health · 2021Article
- Clinical course of asymptomatic malignant pleural effusion in non-small cell lung cancer patients: A multicenter retrospective study.Medicine · 2021Observational
- Development and validation of a deep learning algorithm detecting 10 common abnormalities on chest radiographs.The European respiratory journal · 2021Article
- The cardiothoracic ratio and all-cause and cardiovascular disease mortality in patients undergoing maintenance hemodialysis: results of the MBD-5D study.Clinical and experimental nephrology · 2017Observational
- Cardiothoracic ratio on chest radiograph in pediatric heart disease: How does it correlate with heart volumes at magnetic resonance imaging?Pediatric radiology · 2015Article
- Establishing the Cardiothoracic Ratio Using Chest Radiographs in an Indigenous Ghanaian Population: A Simple Tool for Cardiomegaly Screening.Ghana medical journal · 2015Article
- Diagnostic accuracy of cardiothoracic ratio on admission chest radiography to detect left or right ventricular systolic dysfunction: a retrospective study.Journal of the Royal Society of Medicine · 2015Article
- Cardiothoracic ratio in postmortem computed tomography: reliability and threshold for the diagnosis of cardiomegaly.Forensic science, medicine, and pathology · 2014Article
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7 authors.
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Abstract
objectiveTo determine whether cardiothoracic ratio (CTR), within the range conventionally considered normal, predicted prognosis in patients undergoing coronary angiography.
designCohort study with a median of 7-years follow-up.
settingConsecutive patients undergoing coronary angiography at Barts and The London National Health Service (NHS) Trust. SUBJECTS: 1005 patients with CTRs measured by chest radiography, and who subsequently underwent coronary angiography. Of these patients, 7.3% had a CTR > or =0.5 and were excluded from the analyses. OUTCOMES: All-cause mortality and coronary event (non-fatal myocardial infarction or coronary death). Adjustments were made for age, left ventricular dysfunction, ACE inhibitor treatment, body mass index, number of diseased coronary vessels and past coronary artery bypass graft.
resultsThe risk of death was increased among patients with a CTR in the upper part of the normal range. In total, 94 (18.9%) of those with a CTR below the median of 0.42 died compared with 120 (27.8%) of those with a CTR between 0.42 and 0.49 (log rank test p<0.001). After adjusting for potential confounders, this increased risk remained (adjusted HR 1.45, 95% CI 1.03 to 2.05). CTR, at values below 0.5, was linearly related to the risk of coronary event (test for trend p = 0.024).
conclusionIn patients undergoing coronary angiography, CTR between 0.42 and 0.49 was associated with higher mortality than in patients with smaller hearts. There was evidence of a continuous increase in risk with higher CTR. These findings, along with those in healthy populations, question the conventional textbook cut-off point of > or =0.5 being an abnormal CTR.
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