Accuracy of Chest Radiography plus Electrocardiogram in Diagnosis of Hypertrophy in Hypertension

Autor(es)

Ribeiro, Sergio Marrone ^[1] ; Morceli, Jose ^[1] ; Goncalves, Renato Souza ^[2] ; da Silva Franco, Roberto Jorge ^[2] ; Habermann, Francisco ^[2] ; Meira, Domingos Alves ^[1] ; Matsubara, Beatriz Bojikian ^[2]

Afiliação do(s) autor(es)

^[1] Univ Estadual Paulista, UNESP, Fac Med Botucatu, Dept Doencas Tropicais & Diagnost Imagem, Botucatu, SP - Brazil

^[2] Univ Estadual Paulista, UNESP, Fac Med Botucatu, Dept Clin Med, Botucatu, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Arquivos Brasileiros de Cardiologia; v. 99, n. 3, p. 825-832, SEP 2012.
• Citações Web of Science: 4

Resumo

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. (Arq Bras Cardiol 2012;99(3):825-833) (AU)

• Processo FAPESP: 04/09460-5 - Remodelação miocárdica secundária à sobrecarga fisiológica da gravidez associada à hipertensão arterial crônica
• Beneficiário: Beatriz Bojikian Matsubara
• Modalidade de apoio: Auxílio à Pesquisa - Programa Equipamentos Multiusuários