Role of chest radiographs and electrocardiograms in predicting the hemodynamics of congenital heart disease

Romila Chimoriya, Gaurav Kumar, Kritika Rana, Ritesh Chimoriya, Reena Anand, K. S. Dagar, N. Awasthy
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Abstract

Aim: This study aimed to evaluate the role of chest radiographs and electrocardiograms in predicting the hemodynamics of congenital heart disease (CHD). Methods: This retrospective study included 50 patients with a diagnosis of CHD who had undergone any form of cardiac intervention, either surgical or nonsurgical between September 2019 and September 2020. Chest radiographs and electrocardiograms were evaluated and compared with the diagnostic gold standard echocardiography. Results: Chest radiographs had the highest sensitivity, specificity, and accuracy, with all being 100%, in detecting situs and cardiac position. There was a very good agreement between chest radiographs and echocardiography in the detection of both situs and cardiac position (κ = 1.00, P < 0.001), while moderate agreement was observed for the detection of cardiomegaly, position of the aortic knuckle, main pulmonary artery dilation, and right pulmonary artery dilation. Electrocardiograms had a high sensitivity (100.00%), but modest specificity and accuracy for the detection of left ventricle pressure overload. For the detection of left atrial enlargement and left ventricle volume overload, electrocardiograms had high specificity (94.12% and 94.29%, respectively) but low sensitivity and modest accuracy. There was a moderate agreement between electrocardiograms and echocardiography in the detection of right ventricle pressure overload (κ = 0.43, P = 0.002) and left ventricle volume overload (κ = 0.46, P < 0.001). Conclusions: The study findings indicate that chest radiographs and electrocardiograms alone are not adequate for the assessment of hemodynamics of CHD and reinstates the recommendation that in addition to routine chest radiographs and electrocardiograms, echocardiography should be performed.
胸片和心电图在预测先天性心脏病血液动力学方面的作用
目的:本研究旨在评估胸片和心电图在预测先天性心脏病(CHD)血液动力学方面的作用。研究方法这项回顾性研究纳入了 50 名确诊为先天性心脏病的患者,他们在 2019 年 9 月至 2020 年 9 月期间接受了任何形式的心脏介入治疗,包括手术或非手术治疗。对胸片和心电图进行了评估,并与诊断金标准超声心动图进行了比较。结果:胸片在检测坐位和心脏位置方面具有最高的敏感性、特异性和准确性,均为 100%。胸片和超声心动图在检测坐位和心脏位置方面的一致性非常好(κ = 1.00,P < 0.001),而在检测心脏肥大、主动脉节位置、主肺动脉扩张和右肺动脉扩张方面的一致性一般。心电图在检测左心室压力超负荷方面具有较高的灵敏度(100.00%),但特异性和准确性不高。在检测左心房扩大和左心室容量超负荷方面,心电图的特异性较高(分别为 94.12% 和 94.29%),但敏感性较低,准确性也不高。心电图和超声心动图在检测右心室压力超负荷(κ = 0.43,P = 0.002)和左心室容积超负荷(κ = 0.46,P < 0.001)方面有一定的一致性。结论研究结果表明,仅靠胸片和心电图不足以评估心脏病的血液动力学,因此再次建议除常规胸片和心电图外,还应进行超声心动图检查。
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