A simple ratio can help to identify a patient with left atrial enlargement and cardiogenic pulmonary edema. The authors are from Hopital Pasteur, Hopital l'Archet, Hopital de Cimiez and Hospital Princesse Grace in France and Monaco.
Imaging Study: chest CT in the transverse or horizontal plane at the level of the right inferior pulmonary vein
Exclusions: severe thoracic scoliosis, pericardial effusion, large hiatal hernia
Measurements:
(1) maximum diameter of the left atrium from left to right in cm
(2) diameter of the vertebral body in cm along a line parallel to item 1
ratio =
= (left atrial diameter) / (vertebral body diameter)
Interpretation:
• The mean ratio in an asymptomatic patent is 1.85 +/- 0.27 (1.58 to 2.12)
• A ratio >= 2.1 indicated left atrial enlargement and cardiogenic pulmonary edema.
Performance:
• The cutoff of >= 2.1 had a sensitivity of 85% and specificity of 88%. The area under the ROC curve was 0.93.
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