قدرت تشخيصي مجموعه ي شرح حال ،معاينه ي فيزيكي ، راديوگرافي قفسه ي سينه و نوارقلب در تخمين كارايي سيتوليك بطن چپ

Accuracy of the clinical evaluation, ECG and chest x-ray for prediction of the left ventricular systolic function

Background: It seems that with careful review of the history, physical examination, ECG and standard chest radiography, the left ventricular systolic function can be predicted accurately without need for more complex methods.So this study was performed in patients who referred to Emam Khomani hospital in Tehran in 2001. Materials and Methods: In this descriptive study after taking the past medical history, all patients were examined by one cardiologist and the changes in their ECG and chest x-ray were recorded. Then their left ventricular systolic function were predicted based on the distinct algorithm and classified into three groups: those with normal ejection fraction, probably low or low ejection fraction. Then these results were compared with the results of echocadiography and sensitivity, specificity and positive and negative predictive values of the semi-clinical method were calculated. Results: The estimation of ejection fractions were confirmed by echocardiography in 90% of the first group, 63% of the second group and 13% of the third group. The semi-clinical method (history + physical exam+ ECG + C. R) had 91% sensitivity and 75% specificity for detection of low ejection fraction in left ventriclular. The positive predictive value of this method was 63% and itʹs negative prediction value was 95%. Conclusion: It seems that with careful review of the history, physical examination plus ECG and standard chest radiography, the left ventricular systolic function can be evaluated accurately without need for echocardiography.