Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 15;17(4):3085-3093.
doi: 10.62347/BOIQ3903. eCollection 2025.

Chest CT signs and serum homocysteine levels can effectively diagnose chronic heart failure

Peiyong Zhang  1 , Caiyan Bai  1 , Yonglong Guo  1 , Xiaochen Liu  1 , Penghong Duan  1 , Chaobo Yuan  1
Affiliations

Chest CT signs and serum homocysteine levels can effectively diagnose chronic heart failure

Peiyong Zhang et al. Am J Transl Res. .

Abstract

Objective: Chronic heart failure (CHF) is a significant clinical and public health concern, and improving its diagnostic accuracy remains an urgent challenge. This study aimed to evaluate the diagnostic value of chest computed tomography (CT) signs and serum homocysteine (Hcy) levels in the preoperative diagnosis of CHF.

Methods: Clinical records of 97 patients hospitalized with suspected CHF between January 2019 and December 2023 were retrospectively analyzed. The accuracy, specificity, and sensitivity of chest CT in diagnosing CHF were calculated, using color Doppler echocardiography as the gold standard. Key CT features, including pulmonary venous hypertension (PVH), atrial dilatation (AD), cardiogenic pulmonary edema (CPE), and pleural effusion (PE), were assessed. Serum Hcy levels were compared, and diagnostic performance was evaluated using a receiver operator characteristic (ROC) curves.

Results: The accuracy, sensitivity, and specificity of chest CT for diagnosing CHF were 82.47%, 91.07%, and 70.73%, respectively. Among patients with diagnosed with CHF, 48 (76.19%) had PVH, 44 (69.84%) had CPE, 44 (69.84%) had PE, and 47 (74.60%) had AD. PVH, AD, CPE, and PE were strongly correlated with CHF (all P<0.05). The area under the curve (AUC) for CHF diagnosis was 0.831 for CT alone, 0.824 for Hcy alone, and 0.922 for the combined approach.

Conclusion: Chest CT demonstrated high diagnostic efficiency for CHF, aiding clinicians in preoperative assessment and differentiation. It provides reliable identification of key CHF-related signs, including PVH, AD, CPE, and PE, all of which are strongly correlated with CHF. In addition, integrating serum Hcy levels with imaging findings enhances diagnostic accuracy.

Keywords: Chronic heart failure; chest computed tomography; preoperative diagnosis.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
CT images from a chronic heart failure patient. A: Enlarged and blurred pulmonary hilums, thickened and blurred bronchovascular bundles (arrows), thickened smooth interlobular septa, diffuse ground-glass shadows in the lung fields; B: Mediastinal window in patients with chronic heart failure, presence of a small pericardial effusion.
Figure 2
Figure 2
Pulmonary venous hypertension (PVH) statistics in suspected chronic heart failure (CHF) patients (P<0.0001, χ2=17.81). A: PVH incidence in CHF patients; B: PVH incidence in non-CHF patients; C: ROC curve for PVH for diagnosing CHF.
Figure 3
Figure 3
Statistics of cardiogenic pulmonary edema (CPE) for suspected chronic heart failure (CHF) patients (P=0.013, χ2=6.132). A: CPE incidence in CHF patients; B: CPE incidence in non-CHF patients; C: ROC curve for CPE in diagnosing CHF.
Figure 4
Figure 4
Statistics of pleural effusion (PE) in suspected chronic heart failure (CHF) patients (P=0.0004, χ2=12.641). A: PE incidence in CHF patients; B: PE incidence in non-CHF patients; C: ROC curve for PE for diagnosing CHF.
Figure 5
Figure 5
Statistics of atrial dilatation (AD) in suspected chronic heart failure (CHF) patients (P=0.0002, χ2=14.321). A: AD incidence in CHF patients; B: AD incidence in non-CHF patients; C: ROC curve for AD for diagnosing CHF.
Figure 6
Figure 6
ROC analysis of CT, Hcy and their combination for diagnosing CHF. Hcy: homocysteine; CHF: chronic heart failure.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Roger VL. Epidemiology of heart failure: a contemporary perspective. Circ Res. 2021;128:1421–1434. - PubMed
    1. Groenewegen A, Rutten FH, Mosterd A, Hoes AW. Epidemiology of heart failure. Eur J Heart Fail. 2020;22:1342–1356. - PMC - PubMed
    1. Di Palo KE, Barone NJ. Hypertension and heart failure: prevention, targets, and treatment. Cardiol Clin. 2022;40:237–244. - PubMed
    1. Heo S, Kang J, Shin MS, Lim YH, Kim SH, Kim S, An M, Kim J. Physical symptoms, depressive symptoms, and quality of life in patients with heart failure: cluster analysis. J Cardiovasc Nurs. 2024;39:31–37. - PubMed
    1. Schmeißer A, Rauwolf T, Groscheck T, Fischbach K, Kropf S, Luani B, Tanev I, Hansen M, Meißler S, Schäfer K, Steendijk P, Braun-Dullaeus RC. Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction. ESC Heart Fail. 2021;8:2968–2981. - PMC - PubMed

LinkOut - more resources