[Are thoracic radiographs in the recumbent position useful in the diagnosis of chronic left heart insufficiency? Comparison of x-ray findings with left ventricular hemodynamics].
108 patients (88 male, mean age 50 years, 20 female, mean age 49) having coronary heart disease (40), cardiomyopathy (39), hypertension (9), valvular disease (9), pulmonary diseases (5) and without cardiac diseases (6) underwent chest plain radiographs in standing and recumbent position immediately before being investigated invasively by left and right heart catheterisation, angiocardiography and coronary angiography. Two experienced radiologists evaluated the plain films with special reference to the findings of the heart and lung vessels, particularly the pulmonary veins. Dilatated veins of the upper lobes were observed more often if the radiograph was obtained from the recumbent patient. A significant close correlation with increased LVEDP was, however, revealed in both positions. A possible simulation of pathological dilatation of the venous trunci of the upper lobes merely due to the redistribution of the blood flow in the horizontal position was excluded. The results show that reliable conclusions can be drawn concerning chronic left ventricular failure if the characteristic pulmonary vein findings are visualised in patients both in the standing and in the recumbent position.