Jiang L, et al. - Given that patients with rheumatic heart disease display an enlarged heart commonly, researchers investigated the prognostic value of cardiothoracic ratio (CTR) in patients with rheumatic heart disease undergoing valve replacement surgery. In a total of 1772 patients, they measured CTR from postero-anterior chest radiographs. Males with a CTR >0.6 displayed prevalence of in-hospital death of 7.1%, which was significantly higher in males without a CTR. Findings suggest that CTR is a simple and reproducible indicator that could forecast poor outcomes in these patients.