The vascular pedicle of the heart and the vena azygos. Part II: Acquired heart disease.

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Abstract
To establish the value of the chest radiograph in assessing the hemodynamic status of the systemic circulation, the vascular pedicle width (VPW) and vena azygos width (AW) were correlated with total blood volume (TBV) and other parameters in 61 cardiac patients. In both ischemic and valvular cardiac disease a highly significant linear correlation was found between VPW and TBV (r = 0.80, P < 0.001). In patients with dilated neck veins VPW was > 62 mm (normal 48 .+-. 5 mm). A less significant correlation was found between VPW and mean right atrial pressure (MRAP). Change in VPW correlated strongly (r = 0.93, P < 0.001) with change in TBV (0.5 cm change in VPW = 1.0 l change in TBV). Correlation between AW and TBV was poor (r = 0.50, P < 0.01), but between AW and MRAP the correlation was stronger (r = 0.74, P < 0.001). Changes in AW usually occurred in the same direction as changes in MRAP, but the correlation was not significant (r = 0.45). VPW and AW did not correlate with pulmonary blood volume, pulmonary arterial pressure, stroke volume or heart rate. Radiologic assessment of VPW and AW adds an additional clinically useful dimension to the evaluation of cardiac disease.