Hiraiwa Hiroaki, Nagai Shin, Ito Ryota, Kondo Kiyota, Kazama Shingo, Kondo Toru, Adachi Shiro, Furusawa Kenji, Tanaka Akihito, Morimoto Ryota, Okumura Takahiro, Murohara Toyoaki
Department of Cardiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Int J Cardiovasc Imaging. 2025 Mar;41(3):507-521. doi: 10.1007/s10554-025-03332-x. Epub 2025 Jan 25.
Dynamic chest radiography (DCR) can estimate haemodynamic parameters in heart failure (HF). However, no studies have evaluated its ability to determine cardiac systolic function in HF. This experimental study investigates the correlation between left ventricular (LV) ejection fraction (LVEF) and DCR image parameters in HF. Ninety-one patients with acute HF (median age, 58 years; males, 75%) (cardiologist diagnosis using the Framingham criteria) underwent DCR and transthoracic echocardiography after treatment for the uncompensated phase of HF. The LV apex pixel value (PV) change was measured by DCR. Correlations between the PV change and LVEF, as well as sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of DCR, were evaluated. LVEF and LV apex PV change were correlated in all patients (R = 0.428, P < 0.001) and in patients with LVEF < 50% (n = 38; R = 0.355, P = 0.029), < 40% (n = 31; R = 0.343, P = 0.059), and < 30% (n = 23; R = 0.321, P = 0.135). There was no significant correlation for patients with LVEF ≥ 50% (n = 53; R = - 0.004, P = 0.980). The LV apex PV change rate cutoff values for identifying LVEF < 50%, < 40%, and < 30% were 9.3% (AUC: 0.761, sensitivity: 0.698, specificity: 0.789, P < 0.001), 5.5% (AUC: 0.765, sensitivity: 0.883, specificity: 0.645, P < 0.001), and 5.5% (AUC: 0.767, sensitivity: 0.838, specificity: 0.696, P < 0.001), respectively. DCR may be useful to identify LV systolic dysfunction based on LVEF in acute HF.
动态胸部X线摄影（DCR）可评估心力衰竭（HF）中的血流动力学参数。然而，尚无研究评估其在HF中确定心脏收缩功能的能力。本实验研究调查了HF患者左心室（LV）射血分数（LVEF）与DCR图像参数之间的相关性。91例急性HF患者（中位年龄58岁；男性占75%）（根据Framingham标准由心脏病专家诊断）在HF失代偿期治疗后接受了DCR和经胸超声心动图检查。通过DCR测量LV心尖像素值（PV）变化。评估了PV变化与LVEF之间的相关性，以及DCR的敏感性、特异性和受试者操作特征曲线下面积（AUC）。在所有患者中（R = 0.428，P < 0.001）以及LVEF < 50%（n = 38；R = 0.355，P = 0.029）、< 40%（n = 31；R = 0.343，P = 0.059）和< 30%（n = 23；R = 0.321，P = 0.135）的患者中，LVEF与LV心尖PV变化相关。对于LVEF≥50%的患者（n = 53；R = - 0.004，P = 0.980），未发现显著相关性。识别LVEF < 50%、< 40%和< 30%的LV心尖PV变化率临界值分别为9.3%（AUC：0.761，敏感性：0.698，特异性：0.789，P < 0.001）、5.5%（AUC：0.765，敏感性：0.883，特异性：0.645，P < 0.001）和5.5%（AUC：0.767，敏感性：0.838，特异性：0.696，P < 0.001）。DCR可能有助于根据急性HF患者的LVEF识别LV收缩功能障碍。
