The clinical associations with cardiomegaly in patients undergoing evaluation for pulmonary hypertension. Issue 6 (2nd November 2021)

• Record Type: Journal Article
• Authors: Daines, Benjamin; Rao, Sanjana; Hosseini, Omid; Prieto, Sofia; Abdelmalek, John; Elmassry, Mohamed; Sethi, Pooja; Test, Victor; Nugent, Kenneth
• Is Part Of: Journal of community hospital internal medicine perspectives. Volume 11:Issue 6(2021)
• Page Start: 787
• Page End: 792
• Publication Date: 2021-11-02
• Subjects: Cardiomegaly -- pulmonary hypertension -- right heart catheterization -- echocardiography; Internal medicine -- Periodicals; Hospitals -- Periodicals; Hospitals, Community; Internal Medicine; Hospitals; Internal medicine; Periodicals; Periodicals; 610
• DOI: 10.1080/20009666.2021.1982488
• Languages: English
• ISSNs: 2000-9666

Abstract

ABSTRACT: Background: Chest radiographs can identify important abnormalities in patients undergoing diagnostic evaluation for cardiovascular diseases. Cardiomegaly often reflects cardiac chamber dilation, or cardiac muscle hypertrophy, or both conditions. The clinical implications of cardiomegaly depend on the underlying clinical disorder. Does cardiomegaly have any clinical, laboratory, echocardiographic, and right heart catheterization associations in patients undergoing evaluation for pulmonary hypertension? Methods: Patients referred to a pulmonary vascular disease clinic for possible pulmonary hypertension underwent a comprehensive evaluation that included right heart catheterization. These patients also had chest radiographs, laboratory studies, and echocardiograms. The patients were divided into two groups based on the presence or absence of cardiomegaly. Results: This study included 102 patients (63.7% female) with a mean age of 62.3 ± 15.0 years. Patients with cardiomegaly (n = 64) had elevated BNP, BUN, and creatinine levels. They had elevated right atrial pressures, right ventricular pressures, and pulmonary artery pressures and reduced cardiac indices and reduced mixed venous oxygen saturations. There were no differences in echocardiographic parameters between the two groups. Conclusions: This study demonstrates that the presence of cardiomegaly on chest radiographs has important clinical implications, including increased BNP levels and increased right heart pressures, in patients undergoing evaluation for pulmonary hypertension. Consequently, the presence of cardiomegaly supports the need for additional evaluation, including right heart catheterization, and provides useful information for primary care physicians and specialists.