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Introduction: Chest X–Ray is one of the most common method of imaging. Cardio Thoracic Ratio ( CTR ) is one of the parameters of Chest X–Ray that is used for determining cardiac enlargement. Echocardiography as compared to Chest X–Ray is expensive and all centers dont have it, but it can determine heart size, valvular diseases, Ejection Fraction, Left Ventricular Hypertrophy (LVH), Pericardial effusion and diastolic dysfunction very well. So, this research was done in order to compare CTR with Echocardiographic findings and precent expensive investigations in the future. Methods: In this cross-sectional analytical study from Sep 2006 to Sep2007, CTR of 172 patients referring to Shohadaye Kargar and Goodarz hospitals was determined from their Chest X–Rays and echocardiography was done later. Data was analyzed with SPSS software and statiscal tests such as Chi-square and Fisher exact tests were used. Results: The results of this research wereas folows: 1- The mean age for the patients with increased CTR was higher than patients with normal CTR. 2- Left Ventricular Hypertrophy (LVH) and increases of left and right ventricular diameters increased the CTR. 3- There was no statistical relation between sex, pericardial effusion, left and right atrium diameters and CTR. 4- Patients with increased CTR had more valvular heart diseases, systolic and diastolic dysfunction than patients with normal CTR. Conclusion: Increased CTR is one of the signs of cardiac pathologies and therefore echocardiography is advisable for more evaluation of patients with increased CTR.

Keywords: Cardio Thoracic Ratio(CTR), Chest X–Ray, Echocardiography

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