Abstract
In order to define the relation between chest x-ray findings and the level of pulmonary artery wedge pressure in patients with chronic congestive cardiomyopathy, 82 patients had chest radiographs before undergoing 92 haemodynamic studies. The studies were divided into three groups according to the level of pulmonary artery wedge pressure (PAWP) (group 1: less than 15 mmHg, group 2: 15 to 24 mmHg, group 3: greater than or equal to 25 mmHg. Venous distribution, interstitial oedema, pleural effusions, left atrial enlargement, and right ventricular enlargement each occurred in less than 10 per cent of group 1 studies. Radiological abnormalities generally distinguished group 1 from group 2, but none except cardiothoracic ratio distinguished group 2 from group 3. Cardiothoracic ratio correlated best with pulmonary artery wedge pressure (r = 0.70). Alveolar oedema was uncommon when PAWP greater than or equal to 25 mmHg, occurring in 32 per cent of group 3 studies. Stepwise multiple linear regression analysis showed that cardiothoracic ratio, alveolar oedema, interstitial oedema, and left atrial size each contributed independently to the prediction of PAWP. The regression analysis improved the accuracy of the estimation of PAWP from the findings noted on standard chest radiographs.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chait A. Interstitial pulmonary edema. Circulation. 1972 Jun;45(6):1323–1330. doi: 10.1161/01.cir.45.6.1323. [DOI] [PubMed] [Google Scholar]
- Chatterjee K., Drew D., Parmley W. W., Klausner S. C., Polansky J., Zacherle B. Combination vasodilator therapy for severe chronic congestive heart failure. Ann Intern Med. 1976 Oct;85(4):467–470. doi: 10.7326/0003-4819-85-4-467. [DOI] [PubMed] [Google Scholar]
- Chatterjee K., Parmley W. W., Massie B., Greenberg B., Werner J., Klausner S., Norman A. Oral hydralazine therapy for chronic refractory heart failure. Circulation. 1976 Dec;54(6):879–883. doi: 10.1161/01.cir.54.6.879. [DOI] [PubMed] [Google Scholar]
- Chen J. T., Behar V. S., Morris J. J., Jr, McIntosh H. D., Lester R. G. Correlation of roentgen findings with hemodynamic data in pure mitral stenosis. Am J Roentgenol Radium Ther Nucl Med. 1968 Feb;102(2):280–292. doi: 10.2214/ajr.102.2.280. [DOI] [PubMed] [Google Scholar]
- Franciosa J. A., Mikulic E., Cohn J. N., Jose E., Fabie A. Hemodynamic effects of orally administered isosorbide dinitrate in patients with congestive heart failure. Circulation. 1974 Nov;50(5):1020–1024. doi: 10.1161/01.cir.50.5.1020. [DOI] [PubMed] [Google Scholar]
- GRAINGER R. G. II. Interstitial pulmonary oedema and its radiological diagnosis: a sign of pulmonary venous and capillary hypertension. Br J Radiol. 1958 Apr;31(364):201–217. doi: 10.1259/0007-1285-31-364-201. [DOI] [PubMed] [Google Scholar]
- Harlan W. R., oberman A., Grimm R., Rosati R. A. Chronic congestive heart failure in coronary artery disease: clinical criteria. Ann Intern Med. 1977 Feb;86(2):133–138. doi: 10.7326/0003-4819-86-2-133. [DOI] [PubMed] [Google Scholar]
- Kostuk W., Barr J. W., Simon A. L., Ross J., Jr Correlations between the chest film and hemodynamics in acute myocardial infarction. Circulation. 1973 Sep;48(3):624–632. doi: 10.1161/01.cir.48.3.624. [DOI] [PubMed] [Google Scholar]
- Kovick R. B., Tillisch J. H., Berens S. C., Bramowitz A. D., Shine K. I. Vasodilator therapy for chronic left ventricular failure. Circulation. 1976 Feb;53(2):322–328. doi: 10.1161/01.cir.53.2.322. [DOI] [PubMed] [Google Scholar]
- LAVENDER J. P., DOPPMAN J., SHAWDON H., STEINER R. E. Pulmonary veins in left ventricular failure and mitral stenosis. Br J Radiol. 1962 May;35:293–302. doi: 10.1259/0007-1285-35-413-293. [DOI] [PubMed] [Google Scholar]
- LAVENDER J. P., DOPPMAN J. The hilum in pulmonary venous hypertension. Br J Radiol. 1962 May;35:303–313. doi: 10.1259/0007-1285-35-413-303. [DOI] [PubMed] [Google Scholar]
- MILNE E. N. PHYSIOLOGICAL INTERPRETATION OF THE PLAIN RADIOGRAPH IN MITRAL STENOSIS, INCLUDING A REVIEW OF CRITERIA FOR THE RADIOLOGICAL ESTIMATION OF PULMONARY ARTERIAL AND VENOUS PRESSURES. Br J Radiol. 1963 Dec;36:902–913. doi: 10.1259/0007-1285-36-432-902. [DOI] [PubMed] [Google Scholar]
- Mason D. T., Spann J. F., Jr, Zelis R., Amsterdam E. A. Alterations of hemodynamics and myocardial mechanics in patients with congestive heart failure: pathophysiologic mechanisms and assessment of cardiac function and ventricular contractility. Prog Cardiovasc Dis. 1970 May;12(6):507–557. doi: 10.1016/0033-0620(70)90020-4. [DOI] [PubMed] [Google Scholar]
- McHugh T. J., Forrester J. S., Adler L., Zion D., Swan H. J. Pulmonary vascular congestion in acute myocardial infarction: hemodynamic and radiologic correlations. Ann Intern Med. 1972 Jan;76(1):29–33. doi: 10.7326/0003-4819-76-1-29. [DOI] [PubMed] [Google Scholar]
- Meszaros W. T. Lung changes in left heart failure. Circulation. 1973 Apr;47(4):859–871. doi: 10.1161/01.cir.47.4.859. [DOI] [PubMed] [Google Scholar]
- SHORT D. S. Radiology of the lung in left heart failure. Br Heart J. 1956 Apr;18(2):233–240. doi: 10.1136/hrt.18.2.233. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STEINER R. E. RADIOLOGY OF PULMONARY CIRCULATION. CHAMBERLAIN LECTURE--1963. Am J Roentgenol Radium Ther Nucl Med. 1964 Feb;91:249–264. [PubMed] [Google Scholar]
- Salzmann C., Sutton G. C., Chatterjee K., Kerr I. H., Miller G. A. Assessment of homograft replacement of mitral valve by chest radiographs. Br Heart J. 1972 Feb;34(2):121–128. doi: 10.1136/hrt.34.2.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turner A. F., Lau F. Y., Jacobson G. A method for the estimation of pulmonary venous and arterial pressures from the routine chest roentgenogram. Am J Roentgenol Radium Ther Nucl Med. 1972 Sep;116(1):97–106. doi: 10.2214/ajr.116.1.97. [DOI] [PubMed] [Google Scholar]
- Yatteau R. F., Peter R. H., Behar V. S., Bartel A. G., Rosati R. A., Kong Y. Ischemic cardiomyopathy: the myopathy of coronary artery disease. Natural history and results of medical versus surgical treatment. Am J Cardiol. 1974 Oct 3;34(5):520–525. doi: 10.1016/0002-9149(74)90121-0. [DOI] [PubMed] [Google Scholar]