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Cardiothoracic ratio and left ventricular ejection fraction relationship

A meta-analysis study

Sadi Elasan and Osman Yilmaz
Saudi Medical Journal June 2023, 44 (6) 529-536; DOI: https://doi.org/10.15537/smj.2023.44.6.20230027

References

  1. 1.↵
    2. Baron MS ,
    3. Vitek JL ,
    4. Bakay RA ,
    5. Green J ,
    6. McDonald WM ,
    7. Cole SA ,
    8. DeLong MR.
    MR. Treatment of advanced Parkinson’s disease by unilateral posterior GPi pallidotomy: 4-year results of a pilot study. Mov Disord 2000; 15: 230–237.
    OpenUrlCrossRefPubMedWeb of Science
  2. 2.
    2. Anis S ,
    3. Lai KW ,
    4. Chuah JH ,
    5. Ali SM ,
    6. Mohafez H ,
    7. Hadizadeh M , et al.
    An overview of deep learning approaches in chest radiograph. IEEE Access 2020; 8: 182347–182354.
    OpenUrl
  3. 3.↵
    2. Karaman S.
    Cardiothoracic area ratio for evaluation of ejection fraction in patients. J Clin Anal Med 2019; 10: 188–192.
    OpenUrl
  4. 4.↵
    2. Morales MA ,
    3. Prediletto R ,
    4. Rossi G ,
    5. Catapano G ,
    6. Lombardi M ,
    7. Rovai D.
    Routine Chest X-ray: Still Valuable for the Assessment of Left Ventricular Size and Function in the Era of Super Machines? J Clin Imaging Sci 2012; 2: 25.
    OpenUrlPubMed
  5. 5.↵
    2. Zhu Y ,
    3. Xu H ,
    4. Zhu X ,
    5. Wei Y ,
    6. Yang G ,
    7. XU Y , et al.
    Association between cardiothoracic ratio left ventricular size and systolic function in patients undergoing computed tomography coronary angiography. Exp Ther Med 2014; 8: 1757–1763.
    OpenUrl
  6. 6.↵
    2. Bonow RO ,
    3. Udelson JE.
    Left ventricular diastolic dysfunction as a cause of congestive heart failure: mechanisms and management. Ann Intern Med 1992;117: 502–510.
    OpenUrlCrossRefPubMedWeb of Science
  7. 7.↵
    2. Williams JF ,
    3. Bristow MR ,
    4. Fowler MB , et al.
    Guidelines for the evaluation and management of heart failure: report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Evaluation and Management of Heart Failure). Circulation 1995; 92: 2764–784.
    OpenUrlFREE Full Text
  8. 8.↵
    2. Hasan MA ,
    3. Lee S-L ,
    4. Kim D-H ,
    5. Lim M-K.
    Automatic evaluation of cardiac hypertrophy using cardiothoracic area ratio in chest radiograph images. Comput Methods Programs Biomed 2012;1 05: 95–108.
    OpenUrl
  9. 9.↵
    2. Tsakok MT ,
    3. Gleeson FV.
    The chest radiograph in heart disease. Medicine 2018; 8: 453–457.
    OpenUrl
  10. 10.
    2. Goldsmith SR ,
    3. Dick C.
    Differentiating systolic from diastolic heart failure: pathophysiologic and therapeutic considerations. Am J Med 1993; 95: 645–655.
    OpenUrlCrossRefPubMedWeb of Science
  11. 11.
    Cohn JN and Rector TS. Prognosis of congestive heart failure and predictors of mortality. Am J Cardiol. 1988;62:25A–30A.
    OpenUrlCrossRefPubMed
  12. 12.
    2. Keogh AM ,
    3. Baron DW ,
    4. Hickie JB.
    Prognostic guides in patients with idiopathic or ischemic dilated cardiomyopathy assessed for cardiac transplantation. Am J Cardiol 1990; 65: 903–908.
    OpenUrlCrossRefPubMedWeb of Science
  13. 13.↵
    2. Cintron G ,
    3. Johnson G ,
    4. Francis G ,
    5. Cobb F ,
    6. Cohn JN.
    Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation 1993; 87: VI17–VI23.
    OpenUrlPubMed
  14. 14.
    2. Cohn JN ,
    3. Archibald DG ,
    4. Francis GS ,
    5. Ziesche S ,
    6. Franciosa JA ,
    7. Harston WE , et al.
    Veterans administration cooperative study on vasodilator therapy of heart failure: influence of prerandomization variables on the reduction of mortality by treatment with hydralazine and isosorbide dinitrate. Circulation 1987; 75: IV49–IV54.
    OpenUrlPubMed
  15. 15.↵
    2. Philbin EF ,
    3. Garg R ,
    4. Danisa K ,
    5. Denny M ,
    6. Gosselin G ,
    7. Hassapoyannes C , et al.
    The relationship between cardiothoracic ratio and left ventricular ejection fraction in congestive heart failure. Arch Intern Med 1998; 158: 501–506.
    OpenUrlCrossRefPubMedWeb of Science
  16. 16.↵
    2. White HD ,
    3. Norris RM ,
    4. Brown MA ,
    5. Brandt PW ,
    6. Whitlock RM ,
    7. Wild CJ.
    Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 1987; 76: 44–51.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    2. Woo P ,
    3. Mao S ,
    4. Wang S ,
    5. Detrano RC.
    Left ventricular size determined by electron beam computed tomography predicts significant coronary artery disease and events. Am J Cardiol 1997; 79: 1236–1238.
    OpenUrlCrossRefPubMed
  18. 18.↵
    2. Cohn JN ,
    3. Johnson GR ,
    4. Shabetai R ,
    5. Loeb H ,
    6. Tristani F ,
    7. Rector T , et al.
    Ejection fraction, peak exercise oxygen consumption, cardiothoracic ratio, ventricular arrhythmias, and plasma norepinephrine as determinants of prognosis in heart failure. The V-HeFT VA Cooperative Studies Group. Circulation 1993; 87: VI5–16.
  19. 19.↵
    2. Mensah YB ,
    3. Mensah K ,
    4. Asiamah S ,
    5. H Gbadamosi ,
    6. Idun EA ,
    7. Brakohiapa W , et al.
    Establishing the cardiothoracic ratio using chest radiographs in an indigenous Ghanaian population: A simple tool for cardiomegaly screening. Ghana Med J 2015; 49: 159–164.
    OpenUrlPubMed
  20. 20.↵
    2. Nakamori N ,
    3. Doi K ,
    4. Macmahon H ,
    5. Sasaki Y ,
    6. Montner S.
    Effect of heart-size parameters computed from digital chest radiographs on detection of cardiomegaly.Potential usefulness for computer-aided diagnosis. IInvest Radiol 1991; 26: 546–550.
    OpenUrl
  21. 21.↵
    2. Danzer CS.
    The cardiothoracic ratio: an index of cardiac enlargement. Am J Med Sci 1919;157: 513.
  22. 22.↵
    2. Kearney MT ,
    3. Fox KA ,
    4. Lee AJ ,
    5. Prescott RJ ,
    6. Shah AM ,
    7. Batin PD , et al.
    Predicting death due to progressive heart failure in patients with mild-to-moderate chronic heart failure. J Am Coll Cardiol 2002; 40: 1801–1808.
    OpenUrlFREE Full Text
  23. 23.↵
    2. Truszkiewicz K ,
    3. Poręba R ,
    4. Gać P.
    Radiological Cardiothoracic Ratio in Evidence-Based Medicine. J Clin Med. 2021; 8; 10.
  24. 24.↵
    2. Ernst E ,
    3. Shub C ,
    4. Bailey KR ,
    5. Brown LR ,
    6. Redfield MM.
    Radiographic measurements of cardiac size as predictors of outcome in patients with dilated cardiomyopathy. J Card Fail 2001; 7: 13–20.
    OpenUrlPubMedWeb of Science
  25. 25.
    2. Petrie MC ,
    3. Mc Murray JJ.
    It cannot be cardiac failure because the heart isnot enlarged on the chest X ray. Editorial. Eur J Heart Fai 2003; 5: 117–119.
    OpenUrl
  26. 26.
    2. Epstein FH.
    MRI of left ventricular function. J Nucl Cardiol 2007;14:729–744.
    OpenUrlCrossRefPubMed
  27. 27.↵
    2. Wang F ,
    3. Zhang J ,
    4. Fang W ,
    5. Zhao SH ,
    6. Lu MJ ,
    7. He ZX.
    Evaluation of LV volumes and ejection fraction by gated SPECT and cardiac MRI in patients with dilated cardiomyopathy. Eur J Nucl Med Mol Imaging 2009; 36: 1611–1621.
    OpenUrlCrossRefPubMed
  28. 28.
    2. Browne RF ,
    3. O’Reilly G ,
    4. McInerney D.
    Extraction of the 2-dimensional cardiothoracic ratio from digital PA chest radiographs: correlation with cardiac function and the traditional cardiothoracic ratio. J Digit Imaging 004; 17: 120–123.
  29. 29.
    Clark AL and Coats AJ. Unreliability of cardiothoracic ratio as a marker of left ventricular impairment: comparison with radionuclide ventriculography and echocardiography. Postgrad Med J 2000; 76: 289–291.
    OpenUrlAbstract/FREE Full Text
  30. 30.
    2. Zhang C ,
    3. Ohira M ,
    4. Iizuka T , et al.
    Cardio-ankle vascular index relates to left ventricular ejection fraction in patients with heart failure a retrospective study. Int Heart J 2013; 54: 216–221.
    OpenUrl
  31. 31.
    2. Simkus P ,
    3. Gutierrez GM ,
    4. Banisauskaite A ,
    5. Noreikaite J ,
    6. McCreavy D ,
    7. Penha D , et al.
    Limitations of cardiothoracic ratio derived from chest radiographs to predict real heart size: comparison with magnetic resonance imaging. Insights into Imaging 2021; 12: 1–10.
    OpenUrl
  32. 32.
    2. Śpiewak M ,
    3. Małek ŁA ,
    4. Biernacka EK ,
    5. Kowalski M ,
    6. Michałowska I ,
    7. Hoffman P , et al.
    Cardiothoracic ratio may be misleading in the assessment of right-and left-ventricular size in patients with repaired tetralogy of Fallot. Clin Radiol 2014; 69: e299–e306.
    OpenUrl
  33. 33.
    2. Taqavi S ,
    3. Katebi D ,
    4. Sheykh AH ,
    5. Javadi A.
    The relationship between cardiothoracic ratio of left ventricular ejection fraction in congestive heart failure patients. J Inflamm Dis 2002; 23; 62–66.
    OpenUrl
  34. 34.
    2. Aksu T ,
    3. Guler TE ,
    4. Kaya V ,
    5. Arat N ,
    6. Tufekcioglu O.
    Predictive value of radiographic measurements as a diagnostic marker of systolic heart failure in a retrospective study: An old method, a new approach. Iran J Radiol 2017; 14: e13462.
    OpenUrl
  35. 35.
    2. Ahmed M ,
    3. Hill J.
    A rational approach to assess volume status in patients with decompensated heart failure. Curr Heart Fail Rep 2012; 9: 139–147.
    OpenUrlPubMed
  36. 36.
    2. Okada M ,
    3. Inoue K ,
    4. Iwakura K ,
    5. Onishi T ,
    6. Hikoso S ,
    7. Nakatani D , et al.
    Mechanism and prognostic significance of cardiothoracic ratio in patients with heart failure with preserved ejection fraction-insights from pursuit-hfpef registry. Circulation 2020; 142: A13493–A13493.
    OpenUrl
  37. 37.↵
    2. Borenstein M ,
    3. Hedges LV ,
    4. Higgins JP ,
    5. Rothstein HR.
    A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods 2010; 1: 97–111.
    OpenUrl
  38. 38.↵
    R Core Team 2021. R: A Language and environment for statistical computing (version 4.0). (R packages retrieved from MRAN snapshot 2021.04.01). Available from: https://cran.r-project.org
  39. 39.↵
    2. Cohen J.
    A power primer. Psychol Bull 1992; 112: 155–159.
    OpenUrlCrossRefPubMedWeb of Science
  40. 40.↵
    2. Viechtbauer W.
    Bias and efficiency of meta-analytic variance estimators in the random-effects model. J Educ Behav Stat 2005; 30: 261–293.
    OpenUrlCrossRefWeb of Science
  41. 41.↵
    2. Viechtbauer W.
    Conducting meta-analyses in R with the metafor package. J Stat Softw 2010; 36: 1–48.
    OpenUrlCrossRefPubMed
  42. 42.↵
    2. Cochran William G.
    The combination of estimates from different experiments. Biometrics 1954; 10: 101–129.
    OpenUrlCrossRef
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