Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1590/S0066-782X2012005000073 http://hdl.handle.net/11449/11364 |
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) |
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Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensosAccuracy of chest radiography plus electrocardiogram in diagnosis of hypertrophy in hypertensionChest radiographyelectrocardiographyechocardiographyhypertrophyleft ventricularhypertensionBackground: 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)FUNDAMENTO: A radiografia de tórax e o eletrocardiograma (ECG) tem sido criticados em razão de sua baixa sensibilidade no diagnóstico da Hipertrofia Ventricular Esquerda (HVE) quando comparada ao ecocardiograma. Entretanto, esse exame não está disponível nos centros de atendimento primário para toda a população de hipertensos. OBJETIVO: Avaliar se a radiografia de tórax associada ao eletrocardiograma apresenta acurácia que justifique seu uso na detecção de HVE em hipertensos, bem como a utilidade do índice cardiotorácico e das radiografias oblíquas na avaliação das dimensões das câmaras cardíacas esquerdas. MÉTODOS: Estudo prospectivo realizado em 177 pacientes hipertensos consecutivos, através da radiografia do tórax, eletrocardiograma e ecocardiograma. Testes de acurácia foram utilizados para comparar esses métodos utilizando a ecocardiografia convencional como padrão de referência. RESULTADOS: O índice cardiotorácico mostrou sensibilidade de 17% para o diagnóstico de HVE, somente detectando alterações cardíacas mais acentuadas. As incidências póstero-anterior e perfil tiveram sensibilidade de 52%, aumentando para 54% quando a radiografia de tórax foi associada ao eletrocardiograma. As incidências oblíquas não melhoraram significativamente a acurácia da radiografia de tórax que, por sua vez, apresentou alta especificidade e boa sensibilidade para a detecção do aumento da aorta. Foi interessante notar que essa alteração estava presente em metade dos hipertensos com HVE. CONCLUSÃO: A associação da radiografia de tórax com eletrocardiograma é útil na avaliação inicial de hipertensos para o diagnóstico de hipertrofia ventricular esquerda, especialmente se a ecocardiografia não estiver disponível.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Estadual Paulista, UNESP, Fac Med Botucatu, Dept Doencas Tropicais & Diagnost Imagem, Botucatu, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Clin Med, Botucatu, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Doencas Tropicais & Diagnost Imagem, Botucatu, SP, BrazilUniv Estadual Paulista, UNESP, Fac Med Botucatu, Dept Clin Med, Botucatu, SP, BrazilFAPESP: 04/09460-5Arquivos Brasileiros CardiologiaUniversidade Estadual Paulista (Unesp)Ribeiro, Sergio Marrone [UNESP]Morceli, Jose [UNESP]Goncalves, Renato Souza [UNESP]da Silva Franco, Roberto Jorge [UNESP]Habermann, Francisco [UNESP]Meira, Domingos Alves [UNESP]Matsubara, Beatriz Bojikian [UNESP]2014-05-20T13:33:15Z2014-05-20T13:33:15Z2012-09-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article825-832application/pdfapplication/pdfhttp://dx.doi.org/10.1590/S0066-782X2012005000073Arquivos Brasileiros de Cardiologia. Rio de Janeiro: Arquivos Brasileiros Cardiologia, v. 99, n. 3, p. 825-832, 2012.0066-782Xhttp://hdl.handle.net/11449/11364S0066-782X2012001200008WOS:000309190500011S0066-782X2012001200008-pt.pdfS0066-782X2012001200008-en.pdf6990977122340795Web of Sciencereponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengArquivos Brasileiros de Cardiologia1.318info:eu-repo/semantics/openAccess2024-08-15T15:23:01Zoai:repositorio.unesp.br:11449/11364Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-15T15:23:01Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos Accuracy of chest radiography plus electrocardiogram in diagnosis of hypertrophy in hypertension |
title |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
spellingShingle |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos Ribeiro, Sergio Marrone [UNESP] Chest radiography electrocardiography echocardiography hypertrophy left ventricular hypertension |
title_short |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
title_full |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
title_fullStr |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
title_full_unstemmed |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
title_sort |
Acurácia da radiografia de tórax associada a eletrocardiograma no diagnóstico de hipertrofia em hipertensos |
author |
Ribeiro, Sergio Marrone [UNESP] |
author_facet |
Ribeiro, Sergio Marrone [UNESP] Morceli, Jose [UNESP] Goncalves, Renato Souza [UNESP] da Silva Franco, Roberto Jorge [UNESP] Habermann, Francisco [UNESP] Meira, Domingos Alves [UNESP] Matsubara, Beatriz Bojikian [UNESP] |
author_role |
author |
author2 |
Morceli, Jose [UNESP] Goncalves, Renato Souza [UNESP] da Silva Franco, Roberto Jorge [UNESP] Habermann, Francisco [UNESP] Meira, Domingos Alves [UNESP] Matsubara, Beatriz Bojikian [UNESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Estadual Paulista (Unesp) |
dc.contributor.author.fl_str_mv |
Ribeiro, Sergio Marrone [UNESP] Morceli, Jose [UNESP] Goncalves, Renato Souza [UNESP] da Silva Franco, Roberto Jorge [UNESP] Habermann, Francisco [UNESP] Meira, Domingos Alves [UNESP] Matsubara, Beatriz Bojikian [UNESP] |
dc.subject.por.fl_str_mv |
Chest radiography electrocardiography echocardiography hypertrophy left ventricular hypertension |
topic |
Chest radiography electrocardiography echocardiography hypertrophy left ventricular hypertension |
description |
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) |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-09-01 2014-05-20T13:33:15Z 2014-05-20T13:33:15Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0066-782X2012005000073 Arquivos Brasileiros de Cardiologia. Rio de Janeiro: Arquivos Brasileiros Cardiologia, v. 99, n. 3, p. 825-832, 2012. 0066-782X http://hdl.handle.net/11449/11364 S0066-782X2012001200008 WOS:000309190500011 S0066-782X2012001200008-pt.pdf S0066-782X2012001200008-en.pdf 6990977122340795 |
url |
http://dx.doi.org/10.1590/S0066-782X2012005000073 http://hdl.handle.net/11449/11364 |
identifier_str_mv |
Arquivos Brasileiros de Cardiologia. Rio de Janeiro: Arquivos Brasileiros Cardiologia, v. 99, n. 3, p. 825-832, 2012. 0066-782X S0066-782X2012001200008 WOS:000309190500011 S0066-782X2012001200008-pt.pdf S0066-782X2012001200008-en.pdf 6990977122340795 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Arquivos Brasileiros de Cardiologia 1.318 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
825-832 application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Arquivos Brasileiros Cardiologia |
publisher.none.fl_str_mv |
Arquivos Brasileiros Cardiologia |
dc.source.none.fl_str_mv |
Web of Science reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808128162054275072 |