ArticleJournal of the Royal Society of Medicine2015
Diagnostic accuracy of cardiothoracic ratio on admission chest radiography to detect left or right ventricular systolic dysfunction: a retrospective study.
Article in Journal of the Royal Society of Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- AI-based measurement of cardiothoracic ratio in chest X-rays and prediction of echocardiographic congestive heart failure.International journal of cardiology. Heart & vasculature · 2025Article
- 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
- New parameter for QRS complex low voltage in chagasic cardiomyopathy: the ADOC index.Revista da Sociedade Brasileira de Medicina Tropical · 2025Article
- Cardiothoracic ratio values and trajectories are associated with risk of requiring dialysis and mortality in chronic kidney disease.Communications medicine · 2023Article
- Clinical Data, Chest Radiograph and Electrocardiography in the Screening for Left Ventricular Hypertrophy: The CARJournal of clinical medicine · 2022Article
- Radiological Cardiothoracic Ratio as a Potential Marker of Left Ventricular Hypertrophy Assessed by Echocardiography.Radiology research and practice · 2022Article
- Limitations of cardiothoracic ratio derived from chest radiographs to predict real heart size: comparison with magnetic resonance imaging.Insights into imaging · 2021Article
- Radiological Cardiothoracic Ratio in Evidence-Based Medicine.Journal of clinical medicine · 2021Review
- Is there any diagnostic value of anteroposterior chest radiography in predicting cardiac chamber enlargement?The international journal of cardiovascular imaging · 2019Article
- Which method is best for an early accurate diagnosis of acute heart failure? Comparison between lung ultrasound, chest X-ray and NT pro-BNP performance: a prospective study.Internal and emergency medicine · 2017Article
- A role model for iconoclasts.Journal of the Royal Society of Medicine · 2015Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the diagnostic accuracy of the cardiothoracic ratio on postero-anterior or antero-posterior chest radiographs in predicting left ventricular or right ventricular dysfunction on echocardiography in an inpatient population.
designRetrospective study.
settingTwo secondary care hospitals in the United Kingdom.
participantsFour hundred consecutive inpatient echocardiograms were screened for inclusion along with chest radiographs (both postero-anterior and antero-posterior). The cardiothoracic ratio was calculated from chest radiographs along with quantitative and qualitative measures of left ventricular or right ventricular dysfunction on echocardiography.
main outcome measuresSensitivity and specificity of cardiothoracic ratio across a range of values to detect moderate/severe left ventricular and/or right ventricular dysfunction on echocardiography.
resultsOverall, 272 records met inclusion criteria. The prevalence of left ventricular/right ventricular dysfunction on echocardiography was 26% in an inpatient population with high clinical suspicion of cardiac disease referred for echocardiography. Over a range of cardiothoracic ratio values on postero-anterior films, a value of >0.55 yielded the best sensitivity (62.5%) and specificity (76.5%) for diagnosing left ventricular/right ventricular impairment (positive likelihood ratio 2.56), with a positive predictive value of 29.5%. Cardiothoracic ratio on antero-posterior film was not predictive of left ventricular/right ventricular impairment on echocardiography.
conclusionsIn conclusion, in the context of an acute admission, cardiothoracic ratio measured on postero-anterior or antero-posterior films has limited value in detecting moderate left ventricular and/or right ventricular systolic dysfunction. Previously established absolute values may be unreliable by modern standards.
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