Comparison of Cardiothoracic Ratio between Smokers and Non-smokers Using Chest X-Ray In Tobruk City
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: The cardiothoracic ratio (CTR) has been utilized as an important tool for estimating heart size. It is measured based on a chest radiograph. Smoking is a known risk factor for cardiovascular and pulmonary diseases. Aim: The main aim of the present study was to compare the cardiothoracic ratio (CTR) between smokers (among current and former smokers) and non-smokers using chest X-rays and to assess the prevalence of cardiomegaly in each group. It also evaluates the association between pack-years and CTR among smokers. Methods: A comparative cross-sectional study was conducted on 58 male participants; their age was 18-82 years, classified into smoker and non-smoker categories. Data were collected from several medical centres in Tobruk city. The CTR was measured using posteroanterior (PA) chest X-rays. Smoking history (cigarettes per day, duration, and pack-years) was recorded. Age, diabetes, and hypertension status were registered as potential confounding factors. Data were analyzed utilizing descriptive and inferential statistics; Welch’s independent samples t-test was used to compare the mean CTR between smokers and non-smokers, Spearman’s rank correlation to evaluate the relationship between pack-years and CTR among smokers, and multivariable linear regression to assess the independent relationship between smoking status and CTR after adjustment for age, diabetes, and hypertension. The threshold for statistical significance was chosen at p ˂ 0.05. Result: It represented that, the mean CTR was 0.411 0.031 among non-smokers and 0.434 0.062 among smokers. While smokers had a higher mean CTR than non-smokers, the difference was not statistically significant (p= 0.068). No significant association was observed between pack-years and CTR among smokers (Spearman’s = 0.147 and p= 0.353). In the multivariable linear regression model, smoking status was not independently linked to CTR after controlling for age, diabetes, and hypertension (B= 0.0143, CI%95: -0.0182 to 0.0468, p= 0.380). The whole regression model was statistically significant ( , adjusted =0.120, p=0.028). Conclusion: Smokers demonstrated a slightly higher mean CTR than non-smokers, but the difference was not statistically significant. Additionally, pack-years were not significantly associated with CTR among smokers, and smoking status was not independently correlated with CTR after controlling for age, diabetes, and hypertension
Institution: Tobruk University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7203988944