Assessment of left ventricular systolic function by the chest x-ray: comparison with radionuclide ventriculography.
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.
Høilund-Carlsen
Poul F
PF
Department of Nuclear Medicine, Odense University Hospital, DK-5000 Odense, Denmark.
Gadsbøll
Niels
N
Hein
Ebbe
E
Stage
Poul
P
Badsberg
Jens Henrik
JH
Jensen
Birte Hjort
BH
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*