Simple area-based measurement for multidetector computed tomography to predict left ventricular size
- 194 Downloads
Measures of left ventricular (LV) mass and dimensions are independent predictors of morbidity and mortality. We determined whether an axial area-based method by computed tomography (CT) provides an accurate estimate of LV mass and volume.
A total of 45 subjects (49% female, 56.0 ± 12 years) with a wide range of LV geometry underwent contrast-enhanced 64-slice CT. LV mass and volume were derived from 3D data. 2D images were analysed to determine LV area, the direct transverse cardiac diameter (dTCD) and the cardiothoracic ratio (CTR). Furthermore, feasibility was confirmed in 100 Framingham Offspring Cohort subjects.
2D measures of LV area, dTCD and CTR were 47.3 ± 8 cm2, 14.7 ± 1.5 cm and 0.54 ± 0.05, respectively. 3D-derived LV volume (end-diastolic) and mass were 148.9 ± 45 cm3 and 124.2 ± 34 g, respectively. Excellent inter- and intra-observer agreement were shown for 2D LV area measurements (both intraclass correlation coefficients (ICC) = 0.99, p < 0.0001) and could be confirmed on non-contrast CT. The measured 2D LV area was highly correlated to LV volume, mass and size (r = 0.68; r = 0.73; r = 0.82; all p < 0.0001, respectively). On the other hand, CTR was not correlated to LV volume, mass, size or 2D LV area (all p > 0.27).
Compared with traditionally used CTR, LV size can be accurately predicted based on a simple and highly reproducible axial LV area-based measurement.
KeywordsMultidetector computed tomography Left ventricle Left ventricular size Cardio-thoracic ratio Direct transverse cardiac diameter Framingham Heart Study
This work was supported by the National Heart, Lung and Blood Institute’s Framingham Heart Study (N01-HC-25195), National Institute of Health (NIH, R01 HL080053), and in part by Siemens Medical Solutions. Christopher Schlett was supported by grants from the German Federal Ministry of Education and Research, and Foundation of German Business, Berlin.
- 1.The Multicenter Postinfarction Research Group (1983) Risk stratification and survival after myocardial infarction. New Engl J Med 309:331–336Google Scholar
- 2.Kannel WB, Gordon T, Offutt D (1969) Left ventricular hypertrophy by electrocardiogram. Prevalence, incidence, and mortality in the Framingham study. Annals Intern Med 71:89–105Google Scholar
- 7.Rubens M (1996) The chest x-ray in adult heart disease. In: Julian CAD, Fox KM, Hall RJC, Poole-Wilson PA (eds) Diseases of the heart. Saunders, London, pp 253–283Google Scholar
- 9.Cohn JN, Johnson GR, Shabetai R et al (1993) Ejection fraction, peak exercise oxygen consumption, cardiothoracic ratio, ventricular arrhythmias, and plasma norepinephrine as determinants of prognosis in heart failure. The V-HeFT VA Cooperative Studies Group. Circulation 87:VI5–VI16PubMedGoogle Scholar
- 13.Hodges FJ, Eyster JAE (1926) Estimation of transverse cardiac diameter in man. Arch Intern Med 37:707Google Scholar
- 14.Schlosser T, Mohrs OK, Magedanz A, Voigtlander T, Schmermund A, Barkhausen J (2007) Assessment of left ventricular function and mass in patients undergoing computed tomography (CT) coronary angiography using 64-detector-row CT: comparison to magnetic resonance imaging. Acta Radiol 48:30–35CrossRefPubMedGoogle Scholar
- 18.Greenland P, Bonow RO, Brundage BH et al (2007) ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). Circulation 115:402–426CrossRefPubMedGoogle Scholar
- 21.Fuster V, Topol EJ, Nabel EG (2004) Atherothrombosis and coronary artery disease. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar