Automated assessment of heart chamber volumes and function in patients with previous myocardial infarction using multidetector computed tomography

Background Left ventricular (LV), right ventricular (RV), and left atrial (LA) volumes and functions contain important prognostic information in ischemic heart disease. Because multidetector computed tomography (MDCT) has high spatial resolution, this method may be optimal to obtain this information...

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Published in:Journal of cardiovascular computed tomography 2012-09, Vol.6 (5), p.325-334
Main Authors: Fuchs, Andreas, MD, Kühl, Jørgen Tobias, MD, Lønborg, Jacob, MD, Engstrøm, Thomas, MD, DMSc, Vejlstrup, Niels, MD, PhD, Køber, Lars, MD, DMSc, Kofoed, Klaus F., MD, DMSc
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Atrial Function, Left
Cardiac chambers
Cardiac CT
Cardiac Volume
Cardiac volumes
Cardiovascular
Female
Heart - diagnostic imaging
Heart - physiopathology
Heart Atria - diagnostic imaging
Heart Atria - pathology
Heart Ventricles - diagnostic imaging
Heart Ventricles - pathology
Humans
Image Processing, Computer-Assisted - methods
Left ventricular ejection fraction
Magnetic Resonance Imaging - methods
Male
Middle Aged
Multidetector Computed Tomography
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - pathology
Myocardial Infarction - physiopathology
Myocardium - pathology
Observer Variation
Prospective Studies
Reproducibility of Results
Right ventricular ejection fraction
Ventricular Function, Left
Ventricular Function, Right
Ventricular mass
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Summary:Background Left ventricular (LV), right ventricular (RV), and left atrial (LA) volumes and functions contain important prognostic information in ischemic heart disease. Because multidetector computed tomography (MDCT) has high spatial resolution, this method may be optimal to obtain this information. Objective We evaluated automated assessment for MDCT, by comparing it with cardiac magnetic resonance (CMR). Methods Fifty-three patients with previous myocardial infarction were scanned with 1.5 Tesla CMR and 64-slice MDCT. End-diastolic volume, end-systolic volume, stroke volume, and ejection fraction (EF) were assessed for the left and right ventricle with automatic MDCT software and manual CMR software. LV myocardial mass and cyclic changes in LA volume were derived. Results The mean age of patients was 61 ± 10 years, 40 (75%) were men. Automated MDCT segmentation was possible in all but 2 patients. The average duration of image processing was 21 ± 4 minutes by CMR and 11 ± 4 minutes by MDCT. Bland-Altman plots showed good agreement between MDCT and CMR with only small bias. LVEF by CMR was 56% ± 10% and by MDCT 61% ± 11%, mean difference of −5% (limits of agreement, −18% to 8%), and P < 0.001. RVEF by CMR was 60% ± 5% and by MDCT 56% ± 8%, mean difference of 5% (limits of agreement, −10% to 20%), and P  < 0.001. LA fractional change by CMR was 49% ± 9% and by MDCT 45% ± 9%, mean difference of 4% (limits of agreement, −12% to 20%), and P ≤ 0.001. Conclusion LV, RV, and LA volumes and functions may be evaluated fast and reliably with the use of automated assessment and cardiac MDCT, with good agreement to CMR. Accurate assessment of cardiac chambers with MDCT appears possible in clinical practice.
ISSN:1934-5925
1876-861X
DOI:10.1016/j.jcct.2012.01.006