Jaedicke W, Meuret G, Barmeyer J, Wink K, König K, Reindell H
Med Klin. 1977 Nov 4;72(44):1865-70.
We have investigated the possible relationship between the radiogically determined cardiac volume and the coronary angiogram and laevocardiogram. There was no relationship between cardiac size and coronary angiogram. Independently from the number of coronary vessels involved, we found normal sized hearts in patients without ECG-evidence of myocardial infarction, and enlarged hearts in patients with ECG-evidence of myocardial infarction. There was a significant, though loose relationship between the cardiac volume and the endsystolic and enddiastolic volumes (r=0.73 and 0.55 respectively) and the ejection fraction (r=0.69) as determined by laevocardiography. The critical value of the cardiac size, about which one encounters an increased number of abnormal volume parameters, was the upper boundary of 1-SD. Using this value we found a specifity of 81% and a sensitivity of 74% for the heart volume as a predictor of a pathological ejection fraction. On the other hand, using the upper boundary of 2-SD as a critical value, there was a sensitivity of only 58%, but a specificity of 92%. Only 11% of the patients with a cardiac size in the lower range of normal or below had an ejection fraction below 50%. Therefore the radiologically determined heart size is a simple, in daily practive acceptable method to assess and follow up left ventricular function in coronary patients.
我们研究了放射学测定的心脏容积与冠状动脉造影和左心室造影之间的可能关系。心脏大小与冠状动脉造影之间没有关系。无论受累冠状动脉血管的数量如何，我们发现无心电图证据显示心肌梗死的患者心脏大小正常，而有心电图证据显示心肌梗死的患者心脏增大。心脏容积与左心室造影测定的收缩末期和舒张末期容积（分别为r = 0.73和0.55）以及射血分数（r = 0.69）之间存在显著但不紧密的关系。心脏大小的临界值，即异常容积参数数量增加时所对应的数值，是1个标准差的上限。使用该值，我们发现心脏容积作为病理性射血分数预测指标的特异性为81%，敏感性为74%。另一方面，将2个标准差的上限作为临界值时，敏感性仅为58%，但特异性为92%。心脏大小处于正常范围下限或更低的患者中，只有11%的患者射血分数低于50%。因此，放射学测定的心脏大小是一种简单的、在日常实践中可接受的评估和随访冠心病患者左心室功能的方法。
