Letter to the Editor| Volume 146, ISSUE 1, P95-96, January 07, 2011

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Is small heart syndrome a “heart” disease or low output syndrome?

Published:November 15, 2010DOI:
      The study population comprised 47 patients (16 men and 31 women, mean age: 29±6 years) with a small heart shadow [cardiothoracic ratio (CTR) ≤42%] and severe (S: 25, CTR: 38±4%)) or mild (M: 22, CTR: 40±3%) symptoms, as well as 24 controls (C). Left ventricular (LV) function was determined by echocardiography. The mean LV end-diastolic dimension (mm) values were in the order of S (39±4)<M (43±2)<C (46±5) (p<0.05). The mean cardiac index (L/min/m2) was significantly (p<0.001) smaller in S (2.0±0.4) than in M (2.6±0.5) and C (2.8±0.6). The prevalence of low cardiac index (<2) was significantly (p<0.01) higher in S (60%) than in M (9%) and C (4%). The pathognomonic significance of a small heart should be recognized as a constitutional factor that predisposes individuals to low output syndrome.


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