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Takx, RAP; Vliegenthart, R; Schoepf, UJ; Nance, JW; Bamberg, F; Abro, JA; Carr, CM; Litwin, SE; Apfaltrer, P.
Prognostic value of CT-derived left atrial and left ventricular measures in patients with acute chest pain.
Eur J Radiol. 2017; 86(8): 163-168. Doi: 10.1016/j.ejrad.2016.11.013
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Apfaltrer Paul
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Abstract:
To determine which left atrial (LA) and left ventricular (LV) parameters are associated with future major adverse cardiac event (MACE) and whether these measurements have independent prognostic value beyond risk factors and computed tomography (CT)-derived coronary artery disease measures. This retrospective analysis was performed under an IRB waiver and in HIPAA compliance. Subjects underwent coronary CT angiography (CCTA) using a dual-source CT system for acute chest pain evaluation. LV mass, LV ejection fraction (EF), LV end-systolic volume (ESV) and LV end-diastolic volume (EDV), LA ESV and LA diameter, septal wall thickness and cardiac chamber diameters were measured. MACE was defined as cardiac death, non-fatal myocardial infarction, unstable angina, or late revascularization. The association between cardiac CT measures and the occurrence of MACE was quantified using Cox proportional hazard analysis. 225 subjects (age, 56.2±11.2; 140 males) were analyzed, of whom 42 (18.7%) experienced a MACE during a median follow-up of 13 months. LA diameter (HR:1.07, 95%CI:1.01-1.13permm) and LV mass (HR:1.05, 95%CI:1.00-1.10perg) remained significant prognostic factor of MACE after controlling for Framingham risk score. LA diameter and LV mass were also found to have prognostic value independent of each other. The other morphologic and functional cardiac measures were no significant prognostic factors for MACE. CT-derived LA diameter and LV mass are associated with future MACE in patients undergoing evaluation for chest pain, and portend independent prognostic value beyond traditional risk factors, coronary calcium score, and obstructive coronary artery disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing)
Acute Pain - diagnostic imaging
Acute Pain - pathology
Angina, Unstable - diagnostic imaging
Angina, Unstable - pathology
Chest Pain - diagnostic imaging
Chest Pain - pathology
Computed Tomography Angiography -
Coronary Angiography - methods
Coronary Artery Disease - complications
Female -
Heart Atria - diagnostic imaging
Heart Atria - pathology
Heart Ventricles - diagnostic imaging
Heart Ventricles - pathology
Humans -
Male -
Middle Aged -
Myocardial Infarction - complications
Organ Size -
Predictive Value of Tests -
Prognosis -
Retrospective Studies -
Risk Factors -
Tomography, X-Ray Computed - methods
Ventricular Function, Left - physiology

Find related publications in this database (Keywords)
Computed tomography
Left atrial size
Left ventricular function
Cardiovascular events
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