title: Assessment of left ventricular systolic function by the chest x-ray: comparison with radionuclide ventriculography.
abstract: BACKGROUND
  The value of the plain chest roentgenogram in predicting cardiac status remains controversial.
  
  
  RESULTS
  A total of 111 randomly selected survivors of acute myocardial infarction (age 38 to 83 years) were studied prospectively. X-ray and radionuclide examinations were performed on a morning in the second week after myocardial infarction. From the chest x-ray, left ventricular chamber size and pulmonary vascular congestion were graded visually, and relative cardiac volume was measured to allow for comparison with radionuclide left ventricular end-diastolic volume index (LVEDVI) and left ventricular ejection fraction (LVEF) determined by gated blood pool imaging. Despite significant tendencies for larger radionuclide LVEDVI and lower LVEF with greater radiographic left ventricular size, larger relative cardiac volume, and increasing degrees of pulmonary congestion, wide scatter, and large overlaps between groups precluded reliable radiographic prediction of radionuclide findings. The positive and negative predictive values for radiographic detection of an enlarged LVEDVI ranged from 59% to 80% and 56% to 71%, respectively, and for prediction of a decreased LVEF from 75% to 90% and 40% to 58%, respectively. Accuracy never exceeded 70%.
  
  
  CONCLUSIONS
  Our findings question the value of the chest roentgenogram in the detection and grading of left ventricular systolic dysfunction in patients with recent myocardial infarction.
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, DK-5000 Odense, Denmark.
authors.forename: Poul F
authors.initials: PF
authors.lastname: Høilund-Carlsen
authors.forename: Niels
authors.initials: N
authors.lastname: Gadsbøll
authors.forename: Ebbe
authors.initials: E
authors.lastname: Hein
authors.forename: Poul
authors.initials: P
authors.lastname: Stage
authors.forename: Jens Henrik
authors.initials: JH
authors.lastname: Badsberg
authors.forename: Birte Hjort
authors.initials: BH
authors.lastname: Jensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D015637:Gated Blood-Pool Imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D015635:Radionuclide Ventriculography; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*