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Association between cardiothoracic ratio, left ventricular size and systolic function in patients undergoing computed
Yinsu Zhu1, Hai Xu1, Xiaomei Zhu1
1Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.
Insights
The cardiothoracic ratio (CTR) correlates with left ventricular (LV) size and function only in patients with depressed LV ejection fraction (LVEF). In patients with preserved LVEF, CTR is not a reliable indicator of LV systolic function.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- The cardiothoracic ratio (CTR) is a simple radiographic measure of cardiac silhouette size.
- Left ventricular (LV) systolic function is crucial for assessing cardiac health.
- The relationship between CTR and LV systolic function parameters, particularly in relation to LV ejection fraction (LVEF), requires further elucidation.
Purpose of the Study:
- To investigate the association between CTR and LV systolic function parameters.
- To analyze this association in patients stratified by LVEF (<55% vs. ≥55%).
- To determine if CTR can serve as a reliable indicator of LV size and systolic function across different LVEF groups.
Main Methods:
- A cohort of 203 patients suspected of coronary artery disease was studied.
- Chest radiography and dual-source computed tomography coronary angiography (DSCT-CA) were performed.
- LV end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), and LVEF were measured using DSCT-CA.
Main Results:
- Higher LVEDVI and LVESVI were observed in the depressed LVEF group compared to the preserved LVEF group.
- Significant correlations between CTR and LVEDVI, LVESVI, and LVEF were found exclusively in the depressed LVEF group.
- No significant association between CTR and LV systolic function parameters was detected in patients with preserved LVEF.
Conclusions:
- CTR is correlated with LV size and LVEF in patients with depressed LVEF.
- CTR is not a reliable indicator of LV size and systolic function in patients with preserved LVEF.
- These findings highlight the context-dependent utility of CTR in cardiac assessment.
Abstract:
The present study aimed to investigate the association between cardiothoracic ratio (CTR) and left ventricular (LV) systolic function parameters in patients with or without preserved LV ejection fraction (LVEF). A total of 203 subjects suspected with coronary artery disease underwent chest radiography and dual source computed tomography coronary angiography (DSCT-CA). The LV systolic function parameters: LV end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), and LVEF were measured from the DSCT-CA. The association between CTR and LV systolic function parameters was analyzed according to LVEF value (<55%, depressed LVEF group; versus ≥55%, preserved LVEF group) and CTR value (<0.5, normal range CTR group; versus ≥0.5, larger CTR group). The LVEDVI and LVESVI were higher in the depressed LVEF group compared with the preserved LVEF group (108.56±57.15 vs. 67.52±14.56 ml/m2, P<0.001; and 64.07±37.81 vs. 20.23±7.23 ml/m2, P<0.001, respectively) and lower in the normal range CTR group compared with the larger CTR group (67.10±15.00 vs. 77.30±34.32 ml/m2, P=0.009 and 21.94±8.96 vs. 28.97±26.54 ml/m2, P=0.017, respectively). Significant correlations were found between CTR and LVEDVI, and LVESVI and LVEF in the depressed LVEF group (r=0.66, P<0.001; r=0.65, P<0.001; and r=-0.46, P=0.018, respectively). However, there was no significant association detected between CTR and LV systolic function parameters in the other subgroups. The LVEDVI and LVESVI showed an inverse correlation with the LVEF in each group. Although the CTR was not a reliable indicator of LV size and systolic function in patients with preserved LVEF, it was correlated with LV size and LVEF in patients with depressed LVEF.
