Skip to main content
Log in

Left-sided cardiac chamber evaluation using single-phase mid-diastolic coronary computed tomography angiography: derivation of normal values and comparison with conventional end-diastolic and end-systolic phases

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

With increasing use of prospective scanning techniques for cardiac computed tomography (CT), meaningful evaluation of chamber volumes is no longer possible due to lack of normal values. We aimed to define normal values for mid-diastolic (MD) chamber volumes and to determine their significance in comparison to maximum volumes.

Methods

Normal ranges at MD for left ventricular (LV) volume and mass and left atrial (LA) volume were determined from 101 normal controls. Thereafter, 109 consecutive CT scans, as well as 21 post-myocardial infarction patients, were analysed to determine the relationship between MD and maximum volumes.

Results

MD volumes correlated closely with maximal volumes (r = 0.99) for both LV and LA, and could estimate maximum volumes accurately. LV mass, measured at ED or MD, were very similar (r = 0.99). Abnormal MD volumes had excellent sensitivity and specificity to detect chamber enlargement based on maximal volumes (LV 86 %, 100 %, respectively; LA 100 %, 92 %, respectively).

Conclusion

A single MD phase can identify patients with cardiomegaly or LV hypertrophy with a high degree of accuracy and MD volumes can give an accurate estimate of maximum LV and LA volumes.

Key points

Traditionally, helical cardiac CT provided clinically important information from chamber volume analysis.

Mid-diastolic left atrial and ventricular volumes correlate closely with maximal volumes.

We derive normal values for mid-diastolic left atrial and ventricular volumes and mass.

A single mid-diastolic phase can be used to identify chamber enlargement and hypertrophy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

ED:

end-diastole

ES:

end-systole

MD:

mid-diastole

LV:

left ventricle

LA:

left atrium

LVMDVI:

left ventricular mid-diastolic volume index

LVEDVI:

left ventricular end-diastolic volume index

LAMDVI:

left atrial mid-diastolic volume index

LAESVI:

left atrial end-systolic volume index

MI:

myocardial infarction

References

  1. Nasis A, Mottram PM, Cameron JD, Seneviratne SK (2013) Current and evolving clinical applications of multidetector cardiac CT in assessment of structural heart disease. Radiology 267:11–25

    Article  PubMed  Google Scholar 

  2. Hausleiter J, Meyer TS, Martuscelli E et al (2012) Image quality and radiation exposure with prospectively ECG-triggered axial scanning for coronary CT angiography: the multicenter, multivendor, randomized PROTECTION-III study. J Am Coll Cardiol Img 5:484–493

    Article  Google Scholar 

  3. Halliburton SS, Abbara S, Chen MY et al (2011) SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 5:198–224

    Article  PubMed  PubMed Central  Google Scholar 

  4. Vembar M, Garcia MJ, Heuscher DJ et al (2003) A dynamic approach to identifying desired physiological phases for cardiac imaging using multislice spiral CT. Med Phys 30:1683–1693

    Article  CAS  PubMed  Google Scholar 

  5. Masood S, Gao J, Yang GZ (2002) Virtual tagging: numerical considerations and phantom validation. IEEE Trans Med Imaging 21:1123–1131

    Article  PubMed  Google Scholar 

  6. Lessick J, Fisher Y, Beyar R, Sideman S, Marcus ML, Azhari H (1996) Regional three-dimensional geometry of the normal human left ventricle using cine computed tomography. Ann Biomed Eng 24:583–594

    Article  CAS  PubMed  Google Scholar 

  7. Abadi S, Roguin A, Engel A, Lessick J (2010) Feasibility of automatic assessment of four-chamber cardiac function with MDCT: initial clinical application and validation. Eur J Radiol 74:175–181

    Article  PubMed  Google Scholar 

  8. Ariyarajah V, Kranis M, Apiyasawat S, Spodick DH (2007) Association of myocardial ischemia and coronary angiographic lesions with increased left atrial dimension during exercise tolerance tests among patients without known coronary heart disease. Am J Cardiol 99:1187–1192

    Article  PubMed  Google Scholar 

  9. Truong QA, Bamberg F, Mahabadi AA et al (2011) Left atrial volume and index by multi-detector computed tomography: comprehensive analysis from predictors of enlargement to predictive value for acute coronary syndrome (ROMICAT study). Int J Cardiol 146:171–176

    Article  PubMed  Google Scholar 

  10. Laukkanen JA, Kurl S, Eranen J, Huttunen M, Salonen JT (2005) Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med 165:1788–1793

    Article  PubMed  Google Scholar 

  11. Madaj PM, Pagali SR, Hamirani YS et al (2010) Coronary artery calcium and plaque association with left ventricular mass, assessed by multi-row detector computed tomography. Coron Artery Dis 21:428–434

    Article  PubMed  Google Scholar 

  12. McKay RG, Pfeffer MA, Pasternak RC et al (1986) Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion. Circulation 74:693–702

    Article  CAS  PubMed  Google Scholar 

  13. Seneviratne SK, Truong QA, Bamberg F et al (2010) Incremental diagnostic value of regional left ventricular function over coronary assessment by cardiac computed tomography for the detection of acute coronary syndrome in patients with acute chest pain: from the ROMICAT trial. Circ Cardiovasc Imaging 3:375–383

    Article  PubMed  PubMed Central  Google Scholar 

  14. Khatri PJ, Tandon V, Chen L, Yam Y, Chow BJ (2012) Can left ventricular end-diastolic volumes be estimated with prospective ECG-gated CT coronary angiography? Eur J Radiol 81:226–229

    Article  PubMed  Google Scholar 

  15. Gupta M, Hacioglu Y, Kadakia J et al (2011) Left ventricular volume: an optimal parameter to detect systolic dysfunction on prospectively triggered 64-multidetector row computed tomography: another step towards reducing radiation exposure. Int J Cardiovasc Imaging 27:1015–1023

    Article  PubMed  Google Scholar 

  16. Lin FY, Devereux RB, Roman MJ et al (2008) Cardiac chamber volumes, function, and mass as determined by 64-multidetector row computed tomography: mean values among healthy adults free of hypertension and obesity. J Am Coll Cardiol Img 1:782–786

    Article  Google Scholar 

  17. Ecabert O, Peters J, Schramm H et al (2008) Automatic model-based segmentation of the heart in CT images. IEEE Trans Med Imaging 27:1189–1201

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Jonathan Lessick. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.

One of the authors has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational study, performed at one institution.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan Lessick.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Walker, J.R., Abadi, S., Solomonica, A. et al. Left-sided cardiac chamber evaluation using single-phase mid-diastolic coronary computed tomography angiography: derivation of normal values and comparison with conventional end-diastolic and end-systolic phases. Eur Radiol 26, 3626–3634 (2016). https://doi.org/10.1007/s00330-016-4211-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-016-4211-z

Keywords

Navigation