CORRELATION OF ROENTGEN FINDINGS WITH HEMODYNAMIC DATA IN PURE MITRAL STENOSIS

¹ From the Department of Radiology of the Department of Medicine, Duke University School of Medicine, Durham, North Carolina
² From the Cardiovascular Laboratory of the Department of Medicine, Duke University School of Medicine, Durham, North Carolina

In 60 patients with pure mitral stenosis, roentgenographic examinations of the chest were made within 30 days of complete right and left heart catheterization. The relative accuracy of the different roentgen signs in predicting a mitral valve area of 1.3 cm.² or less was as follows: (1) Kerley's B lines—96 per cent; (2) combined venous and arterial abnormalities in the pulmonary vascular pattern—97 per cent; (3) left atrial enlargement producing more than 12 cm.² posterior deviation of the esophagus—83 per cent; (4) either 1 or 2 plus 3—100 per cent. Marked left atrial enlargement correlated best with atrial fibrillation. For assessing pressures and the resistances, the abnormal pulmonary vascular pattern appeared to be more sensitive than Kerley's B lines. In predicting mean pulmonary arterial pressure, the pulmonary artery/hemithorax ratio was more accurate than the diameter of the right descending pulmonary artery.

It is concluded that in addition to indicating specific hemodynamics, chest roentgenograms provide a sensitive and accurate means of predicting the presence of severe or operative mitral stenosis.

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