Original Research Article

AORTA, Article in Press
DOI: 10.12945/j.aorta.17.092

Diagnostic Utility of Chest Radiography in Predicting Long-Standing Systemic Arterial Hypertension

Hakan Sahin, MD1, Paul Stark, MD2

1 Imaging Sciences, University of Rochester School Of Medicine And Dentistry, Rochester, New York, USA
2 Radiology Service, San Diego VA Healthcare System, La Jolla, California, USA

Abstract

Purpose: To investigate the association of an increased aortic arch width on frontal chest radiographs with systemic hypertension.

Material And Methods: 200 consecutive patients were included in an institutional review board (IRB) approved study protocol. A blood pressure of <130 / 90 mmHg was considered as normal. The relationship between aortic arch width measurement on chest radiography and blood pressure measurements were investigated using Student-T test. The correlation between the aortic arch width and the blood pressure was investigated using Fisher’s exact test. A p value of <0.05 was considered statistically significant.

Results: 200 patients were included: of these, 25 were normotensive and 175 were hypertensive. Utilizing a 3.5 cm cut-off value, 136 patients had ≥ 3.5 cm width of the aortic arch. Utilizing a 4-cm cut-off value, 65 patients had ≥ 4 cm width of the aortic arch. A statistically significant relationship between the aortic arch width on chest radiography and blood pressure measurements was found (p<0.000001). A statistically significant relationship between widths of the aortic arch (cut-off value of 3.5 cm and 4 cm) and the presence of hypertension was also present (p< 0.0001 and p<0.005). The aortic arch width larger than 3.5 cm demonstrated: Positive likelihood (LR) of 2.3, negative LR of 0.39, sensitivity of 73, specificity of 68, PPV of 94, NPV of 26.6, pretest odds of 7, posttest odds of 16 and posttest probability of 94%. The aortic arch width larger than 4 cm demonstrated a Positive LR of 4.50, negative LR of 0.70, sensitivity of 36, specificity of 92, PPV of 97, NPV of 17, pretest odds of 7, posttest odds of 31.5 and posttest probability of 97%.

Conclusion: Aortic arch width measurements on chest radiography can be used to predict the presence of long-standing systemic arterial hypertension.

Cite this article as: Sahin H, Stark P. Diagnostic Utility of Chest Radiography in Predicting Long-Standing Systemic Arterial Hypertension. Aorta (Stamford). DOI: 10.12945/j.aorta.17.092 [In Press]

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