Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease.
OBJECTIVE
To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease.


METHODS
A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter.


RESULTS
The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23) and left ventricular diastolic diameter (r=0.30). The area calculated under the ROC curve was 0.734.


CONCLUSIONS
The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.
Perez
Amanda Arantes
AA
Hospital das Clínicas da Faculdade de Medicina da UFMG e Ecoar - Medicina Diagnóstica. Belo Horizonte, Brasil.
Ribeiro
Antonio Luiz Pinho
AL
Barros
Márcio Vinícius Lins
MV
de Sousa
Marcos Roberto
MR
Bittencourt
Roberto José
RJ
Machado
Fernando Santana
FS
Rocha
Manoel Otávio Costa
MO
D000328:Adult; D000368:Aged; D014355:Chagas Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D013902:Radiography, Thoracic; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*