The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review

The presence of hypertensive left ventricular hypertrophy (LVH) is a risk feature associated with both cardiovascular morbidity and mortality. The aim of this review was to evaluate the available data about the diagnostic value of the cardiothoracic ratio (CTR) in the screening for LVH in patients w...

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Main Authors: Patrycja Matusik, Aleksander Kowal, Amira Bryll, Piotr Sobieraj, Tadeusz J. Popiela, Paweł T. Matusik
Format: Article
Language:English
Published: Via Medica 2025-06-01
Series:Arterial Hypertension
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Online Access:https://journals.viamedica.pl/arterial_hypertension/article/view/104790
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author Patrycja Matusik
Aleksander Kowal
Amira Bryll
Piotr Sobieraj
Tadeusz J. Popiela
Paweł T. Matusik
author_facet Patrycja Matusik
Aleksander Kowal
Amira Bryll
Piotr Sobieraj
Tadeusz J. Popiela
Paweł T. Matusik
author_sort Patrycja Matusik
collection DOAJ
description The presence of hypertensive left ventricular hypertrophy (LVH) is a risk feature associated with both cardiovascular morbidity and mortality. The aim of this review was to evaluate the available data about the diagnostic value of the cardiothoracic ratio (CTR) in the screening for LVH in patients with arterial hypertension. The PubMed and Science Direct databases were searched for terms associated with CTR, LVH, and hypertension. Only articles published in English and available in full text were considered. Finally, 13 papers were selected and analyzed. Hypertensive patients are characterized by increased CTR and left ventricular mass (LVM), when compared to controls. Importantly, mortality among hypertensive patients with a CTR ≥ 0.5 was higher than in those with a CTR < 0.5. In hypertensive patients CTR has varying sensitivities ranging from 16% to 53%, and specificities ranging from 86% to 88.3% for detection of LVH. A combination of CTR ≥ 0.5 with electrocardiographic (ECG) criteria and selected cardiovascular risk factors seems to be a better screening tool for LVH than solely ECG criteria. Thus, providing additional predictive information, especially CTR and clinical data in patients with hypertension, is valuable to improve the diagnostic value of ECG in LVH diagnosis.
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series Arterial Hypertension
spelling doaj-art-6e56f85d36014110b6337e6ad3c50b512025-08-21T06:08:37ZengVia MedicaArterial Hypertension2449-61702449-61622025-06-0129Continuous Publishing10.5603/ah.104790The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic reviewPatrycja Matusik0Aleksander Kowal1Amira Bryll2Piotr Sobieraj3Tadeusz J. Popiela4Paweł T. Matusik5Department of Radiology, Jagiellonian University Medical College, Kraków, PolandDepartment of Neurosurgery, Copernicus Memorial Hospital in Łódź, Comprehensive Cancer Centre and Traumatology, Łódź, PolandDepartment of Diagnostic Imaging, University Hospital, Kraków, PolandDepartment of Internal Medicine, Hypertension, and Vascular Diseases, Medical University of Warsaw, Warsaw, PolandDepartment of Diagnostic Imaging, University Hospital, Kraków, PolandDepartment of Electrocardiology, St. John Paul II Hospital, Kraków, PolandThe presence of hypertensive left ventricular hypertrophy (LVH) is a risk feature associated with both cardiovascular morbidity and mortality. The aim of this review was to evaluate the available data about the diagnostic value of the cardiothoracic ratio (CTR) in the screening for LVH in patients with arterial hypertension. The PubMed and Science Direct databases were searched for terms associated with CTR, LVH, and hypertension. Only articles published in English and available in full text were considered. Finally, 13 papers were selected and analyzed. Hypertensive patients are characterized by increased CTR and left ventricular mass (LVM), when compared to controls. Importantly, mortality among hypertensive patients with a CTR ≥ 0.5 was higher than in those with a CTR < 0.5. In hypertensive patients CTR has varying sensitivities ranging from 16% to 53%, and specificities ranging from 86% to 88.3% for detection of LVH. A combination of CTR ≥ 0.5 with electrocardiographic (ECG) criteria and selected cardiovascular risk factors seems to be a better screening tool for LVH than solely ECG criteria. Thus, providing additional predictive information, especially CTR and clinical data in patients with hypertension, is valuable to improve the diagnostic value of ECG in LVH diagnosis.https://journals.viamedica.pl/arterial_hypertension/article/view/104790cardiothoracic ratioCTRleft ventricular hypertrophyLVHhypertensioncardiovascular risk
spellingShingle Patrycja Matusik
Aleksander Kowal
Amira Bryll
Piotr Sobieraj
Tadeusz J. Popiela
Paweł T. Matusik
The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
Arterial Hypertension
cardiothoracic ratio
CTR
left ventricular hypertrophy
LVH
hypertension
cardiovascular risk
title The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
title_full The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
title_fullStr The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
title_full_unstemmed The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
title_short The role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension: a systematic review
title_sort role of the cardiothoracic ratio in the screening of left ventricular hypertrophy in arterial hypertension a systematic review
topic cardiothoracic ratio
CTR
left ventricular hypertrophy
LVH
hypertension
cardiovascular risk
url https://journals.viamedica.pl/arterial_hypertension/article/view/104790
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