Predictors of echocardiographic abnormalities in asymptomatic individuals with increased cardiothoracic ratio detected on chest radiography

Information from the abstract

Background Cardiomegaly detected on chest radiography (CXR) is frequently encountered in clinical practice, even in asymptomatic individuals. However, its diagnostic value for identifying underlying abnormal cardiac structures in this population remains uncertain. This study investigated the predictors for the structural echocardiographic abnormalities among asymptomatic individuals with increased cardiothoracic ratio detected on chest radiography. Methodology. This is a cross-sectional study of asymptomatic adults who underwent routine health check-ups with increased cardiothoracic ratio (CTR) ≥ 0.5 on routine CXR between 2022 and 2025 at Siriraj Hospital, Bangkok, Thailand. A total of 452 participants with increased CTR on CXR who underwent echocardiography within six months were included. Individuals with known structural heart diseases were excluded. Predictive factors were evaluated, including medical history, abnormalities from physical examination and electrocardiogram (ECG). Results Structural echocardiographic abnormalities were identified in 238 participants (52.7%). In the univariate analysis, age ≥ 65 years, hypertension, presence of a systolic murmur on physical examination, and ECG-detected left ventricular hypertrophy (LVH) were significantly associated with structural echocardiographic abnormalities. However, in the multivariable logistic regression analysis, only age ≥ 65 years, hypertension, and ECG-detected LVH remained independent predictors. Conclusion Age ≥ 65 years, hypertension, and ECG-detected LVH were significant predictors of structural echocardiographic abnormalities among asymptomatic individuals undergoing routine health check-ups with cardiomegaly detected on chest radiography. These findings highlight the importance of integrating clinical assessment with electrocardiographic findings to guide referral decisions for echocardiographic evaluation, particularly in resource-limited settings. Clinical trial number: Not applicable.

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Related topics: Cardiac Imaging and Diagnostics · Health Promotion and Cardiovascular Prevention · Acute Myocardial Infarction Research