Incremental prognostic value of left ventricular function analysis over non-invasive coronary angiography with multidetector computed tomography

Author(s):
Graaf, F.R. de; Werkhoven, J.M. van; Velzen, J.E. van; Antoni, M.L.; Boogers, M.J.; Kroft, L.J.; Roos, A. de (0000-0001-5416-2644); Schalij, M.J.; Jukema, J.W. (0000-0002-3246-8359); Wall, E.E. van der; Schuijf, J.D.; Bax, J.J.
Published
2010
Publication type
Article / Letter to editor

Abstract

The purpose of this study was to determine the prognostic value of computed tomography coronary angiography (CTA)-derived left ventricular (LV) function analysis and to assess its incremental prognostic value over the detection of significant stenosis using CTA. In 728 patients (400 males, mean age 55 +/- A 12 years) with known or suspected CAD, the presence of significant stenosis (a parts per thousand yen 50% stenosis) and LV function were assessed using CTA. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), and LV ejection fraction (LVEF) were calculated. LV function was assessed as a continuous variable and using cutoff values (LVEDV > 215 mL, LVESV > 90 mL, LVEF < 49%). The following events were combined in a composite end-point: all-cause mortality, non-fatal myocardial infarction, and unstable angina pectoris requiring hospitalization. On CTA, a significant stenosis was observed in 221 patients (30%). During follow-up [median 765 days, 25-75th percentile: 493-978] an event occurred in 45 patients (6.2%). After multivariate correction for clinical risk factors and CTA, LVEF < 49% and LVESV > 90 mL were independent predictors of events with an incremental prognostic value over clinical risk factors and CTA. The present results suggest that LV function analysis provides independent and incremental prognostic information beyond anatomic assessment of CAD using CTA.

Left ventricular function computed tomography (CT) prognosis all-cause mortality artery-disease ejection fraction myocardial-infarction diagnostic performance ct echocardiography reconstruction volumes atherosclerosis
Date issued
2010-12-31
Language
English
Is part of
Journal of Nuclear Cardiology (2010), Vol. 17, no. 6, p. 1034-1040
hdl
1887/110055