Document Type : Original Article
Authors
1 Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
2 Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
3 Department of Family Medicine, School of Medicine; Head of Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
4 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Abstract
Background: Early diagnosis of congenital heart disease (CHD) has a significant impact on the prognosis of the patient. This study aimed to determine the sensitivity and specificity of cardiomegaly according to Chest X-ray (CXR) indices in comparison with echocardiography in the diagnosis of CHD in infants.
Methods: In this cross-sectional study, the clinical status of 166 infants aged 2 to 24 months who referred to the Pediatric Ward of Afzalipour Hospital in Kerman and needed CXR for any reason, was evaluated from November 2019 to November 2020. CXR and echocardiography were performed for all infants by a pediatric cardiologist and the probability of CHD was confirmed or ruled out. Therefore, the sensitivity and explicitness of CXR were determined. Data were analyzed using SPSS version 20.
Results: The most common anomalies observed in infants were Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD) and pulmonary stenosis (PS), respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR, for determining cardiomegaly in these infants were 65.7%, 51.1%, 26.4%, and 84.8%, respectively.
Conclusion: The results of this study showed that the sensitivity and specificity of CXR for determining cardiomegaly were 65.7% and 51.1%, respectively. Therefore, when echocardiography is not available, the chances of finding congenital heart abnormalities with the help of CXR will be quite high.
Keywords
- Van Der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis. J Am Coll Cardiol. 2011; 58(21):2241-7. doi: 10.1016/j.jacc.2011.08.025.
- Sun PF, Ding GC, Zhang MY, He SN, Gao Y, Wang JH. Prevalence of congenital heart disease among infants from 2012 to 2014 in Langfang, China. Chin Med J (Engl). 2017; 130(9):1069-73. doi: 10.4103/0366-6999.204923.
- Sun RR, Liu M, Lu L, Zheng Y, Zhang P. Congenital heart disease: Causes, diagnosis, symptoms, and treatments. Cell Biochem Biophys. 2015; 72(3):857-60. doi: 10.1007/s12013-015-0551-6.
- Rahim F, Ebadi A, Saki G, Remazani A. Prevalence of congenital heart disease in Iran: A clinical study. J Med Sci. 2008; 8(6):547-52. [In Persian]
- Birkebæk NH, Hansen LK, Elle B, Andersen PE, Friis M, Egeblad M, et al. Chest roentgenogram in the evaluation of heart defects in asymptomatic infants and children with a cardiac murmur: Reproducibility and accuracy. Pediatrics. 1999;103(2):e15. doi: 10.1542/peds.103.2.e15.
- Laya BF, Goske MJ, Morrison S, Reid JR, Swischuck L, Ey EH, et al. The accuracy of chest radiographs in the detection of congenital heart disease and in the diagnosis of specific congenital cardiac lesions. Pediatr Radiol. 2006; 36(7):677-81. doi: 10.1007/s00247-006-0133-2.
- Molaie A, Abdinia B, Zakeri R, Talei A. Diagnostic value of chest radiography in pediatric cardiovascular diseases: A retrospective study in Tabriz, Northwest of Iran. International Journal of Pediatrics. 2015; 3(2/1):9-13. doi: 22038/IJP.2015.4002.
- Fonseca B, Chang RK, Senac M, Knight G, Sklansky MS. Chest radiography and the evaluation of the neonate for congenital heart disease. Pediatr Cardiol. 2005; 26(4):367-72. doi: 10.1007/s00246-005-8649-z.
- Satou GM, Lacro RV, Chung T, Gauvreau K, Jenkins KJ. Heart size on chest X-ray as a predictor of cardiac enlargement by echocardiography in children. Pediatr Cardiol. 2001; 22(3):218-22. doi: 10.1007/s002460010207.
- Caffey J. Pediatric X-ray diagnosis. 7th ed; 1978. p. 543.
)