UNASSIGNED:心胸比>0.50被广泛用作心脏肥大的指标,但心胸比率与左心室收缩功能障碍(LVSD)之间的关联以前尚未研究过.我们进行了这项研究,以探讨使用计算机断层扫描(CT)测量的心胸比与左心室射血分数(LVEF)之间的关系,并确定预测左心室收缩功能障碍(LVSD)的最佳心胸比。
UNASSIGNED:使用2021年1月1日至12月31日在急诊科接受胸部CT和超声心动图检查的患者的数据进行了回顾性横断面研究。患者被归类为正常,或者有温和的,中度,和基于LVEF的严重LVSD,比较各组的心胸比率。受试者工作特征(ROC)曲线分析用于确定用于预测轻度,中度,严重的LVSD
未经证实:最终研究人群包括444名患者。LVEF正常的患者,CT测量的心胸比率中位数为0.54,LVSD患者为0.60(P<0.001)。最佳的CT测量心胸比率预测轻度,中度,和重度LVSD分别为0.56、0.59、0.60,其ROC曲线下面积分别为0.653、0.690、0.680,阴性预测值为90%,94%,98%,分别。
UNASSIGNED:CT测量的提示LVSD的心胸比率的最佳临界值为0.56,这与通常被认为是异常心胸比率的0.50值非常不同。CT测得的心胸比>0.56可作为轻度LVSD的粗略指标,比值≤0.60实际上可以排除严重的LVSD。
OBJECTIVE: A cardiothoracic ratio ≥0.50 is widely used as an indicator of cardiomegaly, but associations between the cardiothoracic ratio and left ventricular systolic dysfunction (LVSD) have not been investigated previously. We conducted this study to investigate the relationship between cardiothoracic ratio measured using computed tomography (CT) and left ventricular ejection fraction (LVEF), and to determine the optimal cardiothoracic ratio for predicting left ventricular systolic dysfunction (LVSD).
METHODS: A retrospective cross-sectional study was performed using data from patients who underwent both chest CT and echocardiography at the emergency department from January 1 to December 31, 2021. The patients were classified as normal, or having mild, moderate, and severe LVSD based on their LVEF, and the cardiothoracic ratios of each group were compared. The receiver operating characteristic (ROC) curve analyses were used to identify the optimal cardiothoracic ratio for prediction of mild, moderate, and severe LVSD.
RESULTS: The final study population included 444 patients. The median CT-measured cardiothoracic ratio was 0.54 for patients with normal LVEF, and 0.60 for patients with LVSD (P<0.001). The optimal CT-measured cardiothoracic ratios for predicting mild, moderate, and severe LVSD were 0.56, 0.59, and 0.60, and their areas under the ROC curve were 0.653, 0.690, and 0.680, and negative predictive values were 90%, 94%, and 98%, respectively.
CONCLUSIONS: The best cutoff value for a CT-measured cardiothoracic ratio suggestive of LVSD was 0.56, which is very different from the 0.50 value typically considered an abnormal cardiothoracic ratio. The CT-measured cardiothoracic ratio ≥0.56 can be used as a rough indicator of mild LVSD, and a ratio <0.60 can exclude severe LVSD with a high degree of confidence.