The Shrinking Heart in Chronic Obstructive Pulmonary Disease

In patients with emphysema, the cardiac silhouette on the radiograph is typically long and narrow. The common explanation for this finding is the altered, more vertical position of the heart in the thoracic cavity. The study by Barr et al. in this issue of the Journal provides an alternative explanation for this radiographic finding: a decreased left ventricular volume.1 The question of whether left ventricular volume is normal in chronic obstructive pulmonary disease (COPD) has been discussed for many years.2 In the 1980s and 1990s, several techniques became available to accurately measure ventricular volumes and cardiac function in patients with . . .