Document Detail

Accuracy of chest radiography plus electrocardiogram in diagnosis of hypertrophy in hypertension.
MedLine Citation:
PMID:  22858617     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Chest radiography and electrocardiogram have been criticized due to their low sensitivity for Left Ventricular Hypertrophy diagnosis compared to echocardiogram. This one, however, is not available in primary health care centers to all hypertensive population.
OBJECTIVE: To evaluate whether the association chest radiography-electrocardiogram provides the accuracy to justify its use in left ventricular hypertrophy detection in hypertensive patients, as well as the usefulness of the cardiothoracic ratio and oblique radiographs in relation to frontal and lateral views in evaluating dimensions of left cardiac chambers.
METHODS: This was a prospective study including 177 consecutive hypertensive patients through chest radiography, electrocardiogram and echocardiography. Accuracy test was used to compare these methods using echocardiography as gold standard.
RESULTS: The cardiothoracic ratio showed 17% sensitivity for detection of left ventricular hypertrophy, only indicating cardiac alterations at an advanced stage. Frontal plus lateral views showed sensitivity of 52%, which rose to 54% when chest radiography was associated with electrocardiogram. The oblique views did not significantly improve chest radiography accuracy. Chest radiography presented high specificity and elevated sensitivity for detection of aortal enlargement. Interestingly, this alteration was present in half of the hypertensive patients with left ventricular hypertrophy.
CONCLUSION: We conclude that the association chest radiography-electrocardiogram is useful for the screening of hypertensive patients for the diagnosis of left ventricular hypertrophy, especially if echocardiogram is unavailable.
Sergio Marrone Ribeiro; José Morceli; Renato Souza Gonçalves; Roberto Jorge da Silva Franco; Francisco Habermann; Domingos Alves Meira; Beatriz Bojikian Matsubara
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-02
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  99     ISSN:  1678-4170     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-26     Completed Date:  2013-04-23     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  825-33     Citation Subset:  IM    
Departamento de Doenças Tropicais e Diagnóstico por Imagem, Faculdade de Medicina de Botucatu, UNESP - Universidade Estadual Paulista, Brazil.
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MeSH Terms
Aged, 80 and over
Cross-Sectional Studies
Hypertension / complications*
Hypertrophy, Left Ventricular / radiography*,  ultrasonography
Middle Aged
Prospective Studies
Radiography, Thoracic
Sensitivity and Specificity
Young Adult
Comment In:
Arq Bras Cardiol. 2013 Apr;100(4):386   [PMID:  23681210 ]

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