The Role of Conventional Chest X-Rays in Monitoring the Therapeutic Response in Patients with Congestive Heart Failure with Cardiomegaly and Pleural Effusion: A Literature Review

Sitti Rafiqah Alwi; Rahmawati Rahmawati; Fadillah Maricar

doi:10.71435/742295

Authors

Sitti Rafiqah Alwi Faculty of Medicine, Universitas Muslim Indonesia
Rahmawati Faculty of Medicine, Universitas Muslim Indonesia
Fadillah Maricar Faculty of Medicine, Universitas Muslim Indonesia

DOI:

https://doi.org/10.71435/742295

Keywords:

Conventional Chest X-Ray, Congestive Heart Failure, Cardiomegaly, Pleural Effusion, Therapy Monitoring, Literature Review

Abstract

Congestive heart failure is a progressive clinical syndrome with a global prevalence of 64.3 million cases. Cardiomegaly and pleural effusion are the main radiological manifestations requiring close monitoring during hospitalization. Conventional chest X-ray is an accessible, low-cost modality that can be performed serially to assess therapy response. The objective of the research to systematically review scientific evidence regarding the role of conventional chest X-ray in monitoring therapy response in Congestive heart failure patients with cardiomegaly and pleural effusion through a literature review approach. This study used a systematic literature review design. Literature searches were conducted in PubMed, Google Scholar, Cochrane Library, and Science Direct databases using keywords: conventional chest X-ray, congestive heart failure, cardiomegaly, pleural effusion, and therapy monitoring. Inclusion criteria included articles published from 2018-2024 with RCT, cohort, cross-sectional, systematic review, and meta-analysis designs. Literature selection used the PRISMA protocol. A total of 30 articles meeting the criteria were analyzed narratively and synthetically. Results showed that literature review showed that the Cardiothoracic Ratio (CTR) and pleural effusion grading on conventional chest X-ray are valid and reliable radiological parameters for monitoring CHF therapy response. CTR change ≥0.02 significantly correlates with hemodynamic and clinical improvement. Serial chest X-rays had sensitivity of 78-85% and specificity of 80-88% in detecting changes in congestion status. Pleural effusion grading significantly correlated with echocardiographic findings (r=0.71). Conventional chest X-ray is proven to play an important role in monitoring therapy response in CHF patients with cardiomegaly and pleural effusion. Systematic use of serial chest X-rays is recommended as part of the standard monitoring protocol for hospitalized Congestive heart failure patients.

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