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Accuracy of chest radiographs in the emergency diagnosis of heart failure

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Abstract

The purpose of this study was to determine the diagnostic accuracy of chest radiographic findings of heart failure (HF) in current patients presenting with dyspnea in the emergency department. In a secondary analysis of the BASEL study, initial chest radiographs of 277 patients with acute dyspnea were evaluated by two radiologists blinded to the adjudicated diagnosis (56% had the final diagnosis of HF). Predefined radiographic criteria of HF were used. Statistical analysis included receiver-operating characteristic (ROC) analysis and calculation of a logistic regression model including B-type natriuretic peptide (BNP) levels. The reader’s overall impression showed the highest area under the ROC curve for the diagnosis of HF in both supine and erect patient positions (0.855 and 0.857). Among individual radiographic findings, peribronchial cuffing in the supine position (0.829) showed the highest accuracies. The lowest accuracy was found for the vascular pedicle width in the supine position (0.461). Logistic regression analysis showed no significant differences between the reader’s overall impression, the radiographic model, and BNP testing. In our study, the combination of radiographic features provided valuable information and was of comparable accuracy as BNP-testing for the diagnosis of HF.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Ueli Studler, Martin Kretzschmar & Wolfgang Steinbrich

  2. Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland

    Michael Christ, Tobias Breidthardt, Markus Noveanu, André P. Perruchoud & Christian Mueller

  3. Institute of Biostatistics, Malzgasse 9, 4052, Basel, Switzerland

    Andreas Schoetzau

  4. Petersgraben 4, 4056, Basel, Switzerland

    Ueli Studler

Authors
  1. Ueli Studler
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  2. Martin Kretzschmar
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  3. Michael Christ
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  4. Tobias Breidthardt
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  5. Markus Noveanu
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  6. Andreas Schoetzau
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  7. André P. Perruchoud
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  8. Wolfgang Steinbrich
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  9. Christian Mueller
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Corresponding author

Correspondence to Ueli Studler.

Additional information

This study was supported by research grants from the Swiss National Science Foundation and the Swiss Heart Foundation. Neither the authors nor the funding organizations have a conflict of interest.

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Studler, U., Kretzschmar, M., Christ, M. et al. Accuracy of chest radiographs in the emergency diagnosis of heart failure. Eur Radiol 18, 1644–1652 (2008). https://doi.org/10.1007/s00330-008-0930-0

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  • DOI: https://doi.org/10.1007/s00330-008-0930-0

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