Correlation of Cardiothoracic Ratio and Right Ventricular Systolic Pressure in Systemic Sclerosis

Abstract

Objective. This study was designed to assess sequential association between right ventricular systolic pressure and cardiothoracic (C/T) ratio of chest radiography in systemic sclerosis (SSc) patients and inferred pulmonary arterial hypertension by increased C/T ratio and right ventricular systolic pressure. Methods. Twenty-eight consecutive patients with confirmed SSc (22 females, 6 males; mean age 51.1±2.1 years), with a mean time of 91.0±6.7 months from SSc diagnosis, were prospectively included in the study. C/T ratio was obtained by chest radiography with an interval of two years. The first C/T ratio was taken at diagnosis and second C/T ratio was taken at the time of enrollment. The enrolled subjects were agree to undergo echocardiography and measurement of brain natriuretic peptide. Results. In 24 SSc patients with normal right ventricular systolic pressure, 10 SSc patients had increased C/T ratio, the other four SSc patients with increased right ventricular systolic pressure by echocardiography, had increased C/T ratio all together. In four SSc patients with increased right ventricular systolic pressure, one patient had resting dyspnea, taken cardiac catheterization and confirmed as pulmonary hypertension and the other three patients had no clinical symptoms. The increased right ventricular systolic pressure is related to the increase of C/T ratio (＞0.55) in chest radiography (p＜0.05) and increased brain natriuretic peptide in blood (p＜0.05). Conclusion. The increase of C/T ratio (＞0.55) in chest radiography was associated with increased right ventricular systolic pressure measured by echocardiography and inferred a role in early detection of asymptomatic pulmonary arterial hypertension in SSc patients. (J Rheum Dis 2015;22:19-24)