| Summary: | Mitral stenosis is one of cardiovascular disease related to problem in mitral
valves. Thus in early stage often asymptomatic. Left atrial enlargement is the common
sign of chronic mitral stenosis, which sometimes will continue as cardiac aritmias,
therefore increase morbidity and mortality. Left atrium lies just inferior to the cartilage
junction between left and right primary bronchi�the carina�and directly contacted with
the inferior surface of left primary bronchus. In a normal PA projection chest X-ray, left
atrial chamber is hardly visualized due to its superimposition with other cardiac
chambers. Left atrial enlargement will be easily noticed when there is adjacent tissues
deviation. Enlarged left atrial will push left primary bronchus in superoposteriorly
direction, causes increasing of the subcarinal angle. Upright PA chest X-ray is able to
predict the availability of mitral stenosis from its subcarinal angle size. The larger the left
atrial the bigger the size of subcarinal angle.
The aim of this study was to evaluate the correlation between the subcarinal angle
size and left atrial enlargement in mitral stenosis. Radiologists in periferal clinics, that
sometimes struggling with limitation of diagnostic modality such as echocardiography
and human resource, can use the increasing of subcarinal angle size in upright PA chest
X-ray as a predictor for mitral stenosis.
This is a retrospective, analytic nor-experimental study with cross sectional
design in Dr. Sardjito General Hospital, on October 2013. Subjects were mitral stenosis
patients who had been diagnosed by cardiologists and also as internal control group, all
compatible with the inclusion and exclusion criterias. Diameter of the left atrium had
been measured by echocardiography. All subjects had upright PA chest X-ray. Subjects
were selected with consecutive sampling method until minimum sample obtained. Left
atrial diameter and the size of subcarinal angle were measured and statistically analized
using correlation test (Pearson/Spearman). Linear regression test was used to evaluate the
degree of correlation.
The study was conducted with a cross sectional design. Subjects were 54 mitral
stenosis patients whom had been examined with echocardiography for left atrial diameter.
Left atrial measurements were conducted by cardiologist. Subjects also underwent an
upright chest X-ray PA examination and those should meet the inclusion and exclusion
criterias with an internal comparison group. Subjects were selected by consecutive
sampling at Dr. Sardjito General Hospital, in October 2013. Baseline measurement is the
size of subcarinal angle. Pearson correlation analysis test revealed that r = 0.298.
It was concluded that there was a significant positive correlation despite weak
correlation strength between the size of subcarinal angle on an upright chest X-ray PA
and left atrial enlargement in patients with mitral stenosis.
|
|---|