[The prognostic significance of the initial thoracic radiogram in acute myocardial infarct].
Chest X-rays provide with indirect evaluation of left ventricular dysfunction after acute myocardial infarction, because of the effects of acute left heart decompensation on pulmonary circulation. To assess the prognostic value of the initial chest X-ray, radiographs were obtained from 194 patients within 24 hours of admission after acute transmural myocardial infarction; 90 patients were treated with thrombolysis and 56 of them presented findings of reperfusion. The one-year survival rate after acute myocardial infarction, correlated with radiographic findings of pulmonary congestion on admission chest X-rays, is significantly reduced (p < 0.01) in the patients with grades III and IV of pulmonary venous congestion (< 35%). Increased cardiothoracic ratio causes early mortality to rise, particularly in the patients with pulmonary congestion (p < 0.05). These results are plain in the group of patients treated with thrombolysis but without reperfusion, or in untreated patients. The present study emphasizes the prognostic role of the initial chest X-ray, which is a noninvasive and cost-effective technique, in the patients with acute myocardial infarction.
Fattori
R
R
Istituto di Radiologia II Cattedra, Università degli Studi di Bologna.
Giampalma
E
E
Di Gaetano
R
R
Golfieri
R
R
Bacchi Reggiani
L
L
Branzi
A
A
Gavelli
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D013902:Radiography, Thoracic / Q000706:statistics & numerical data; D012307:Risk Factors; D016019:Survival Analysis; D015912:Thrombolytic Therapy; D013997:Time Factors
Significato prognostico del primo radiogramma del torace nell'infarto miocardico acuto.