Skip to main content
Top
Published in: European Radiology 7/2010

01-07-2010 | Cardiac

Simple area-based measurement for multidetector computed tomography to predict left ventricular size

Authors: Christopher L. Schlett, Dylan C. Kwait, Amir A. Mahabadi, Fabian Bamberg, Christopher J. O’Donnell, Caroline S. Fox, Udo Hoffmann

Published in: European Radiology | Issue 7/2010

Login to get access

Abstract

Objective

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.

Method

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.

Results

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).

Conclusion

Compared with traditionally used CTR, LV size can be accurately predicted based on a simple and highly reproducible axial LV area-based measurement.
Literature
1.
go back to reference The Multicenter Postinfarction Research Group (1983) Risk stratification and survival after myocardial infarction. New Engl J Med 309:331–336 The Multicenter Postinfarction Research Group (1983) Risk stratification and survival after myocardial infarction. New Engl J Med 309:331–336
2.
go back to reference Kannel WB, Gordon T, Offutt D (1969) Left ventricular hypertrophy by electrocardiogram. Prevalence, incidence, and mortality in the Framingham study. Annals Intern Med 71:89–105 Kannel WB, Gordon T, Offutt D (1969) Left ventricular hypertrophy by electrocardiogram. Prevalence, incidence, and mortality in the Framingham study. Annals Intern Med 71:89–105
3.
go back to reference Lee TH, Hamilton MA, Stevenson LW et al (1993) Impact of left ventricular cavity size on survival in advanced heart failure. Am J Cardiol 72:672–676CrossRefPubMed Lee TH, Hamilton MA, Stevenson LW et al (1993) Impact of left ventricular cavity size on survival in advanced heart failure. Am J Cardiol 72:672–676CrossRefPubMed
4.
go back to reference Abernethy M, Sharpe N, Smith H, Gamble G (1991) Echocardiographic prediction of left ventricular volume after myocardial infarction. J Am Coll Cardiol 17:1527–1532CrossRefPubMed Abernethy M, Sharpe N, Smith H, Gamble G (1991) Echocardiographic prediction of left ventricular volume after myocardial infarction. J Am Coll Cardiol 17:1527–1532CrossRefPubMed
5.
go back to reference Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New Engl J Med 322:1561–1566PubMed Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New Engl J Med 322:1561–1566PubMed
6.
go back to reference White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ (1987) Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 76:44–51PubMed White HD, Norris RM, Brown MA, Brandt PW, Whitlock RM, Wild CJ (1987) Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 76:44–51PubMed
7.
go back to reference 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 253–283 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 253–283
8.
go back to reference Davis JL, Murphy ML, Blue LR, Ferris EJ (1986) A comparison of objective measurements on the chest roentgenogram as screening tests for right or left ventricular hypertrophy. Am J Cardiol 58:658–660CrossRefPubMed Davis JL, Murphy ML, Blue LR, Ferris EJ (1986) A comparison of objective measurements on the chest roentgenogram as screening tests for right or left ventricular hypertrophy. Am J Cardiol 58:658–660CrossRefPubMed
9.
go back to reference 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–VI16PubMed 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–VI16PubMed
10.
go back to reference Giamouzis G, Sui X, Love TE, Butler J, Young JB, Ahmed A (2008) A propensity-matched study of the association of cardiothoracic ratio with morbidity and mortality in chronic heart failure. Am J Cardiol 101:343–347CrossRefPubMed Giamouzis G, Sui X, Love TE, Butler J, Young JB, Ahmed A (2008) A propensity-matched study of the association of cardiothoracic ratio with morbidity and mortality in chronic heart failure. Am J Cardiol 101:343–347CrossRefPubMed
11.
go back to reference Clark AL, Coats AJ (2000) Unreliability of cardiothoracic ratio as a marker of left ventricular impairment: comparison with radionuclide ventriculography and echocardiography. Postgrad Med J 76:289–291CrossRefPubMed Clark AL, Coats AJ (2000) Unreliability of cardiothoracic ratio as a marker of left ventricular impairment: comparison with radionuclide ventriculography and echocardiography. Postgrad Med J 76:289–291CrossRefPubMed
13.
go back to reference Hodges FJ, Eyster JAE (1926) Estimation of transverse cardiac diameter in man. Arch Intern Med 37:707 Hodges FJ, Eyster JAE (1926) Estimation of transverse cardiac diameter in man. Arch Intern Med 37:707
14.
go back to reference 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 48:30–35CrossRefPubMed 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 48:30–35CrossRefPubMed
15.
go back to reference Mao S, Takasu J, Child J, Carson S, Oudiz R, Budoff MJ (2003) Comparison of LV mass and volume measurements derived from electron beam tomography using cine imaging and angiographic imaging. Int J Cardiovasc Imaging 19:439–445CrossRefPubMed Mao S, Takasu J, Child J, Carson S, Oudiz R, Budoff MJ (2003) Comparison of LV mass and volume measurements derived from electron beam tomography using cine imaging and angiographic imaging. Int J Cardiovasc Imaging 19:439–445CrossRefPubMed
16.
go back to reference Joemai RM, Geleijns J, Veldkamp WJ, Kroft LJ (2008) Clinical evaluation of 64-slice CT assessment of global left ventricular function using automated cardiac phase selection. Circ J 72:641–646CrossRefPubMed Joemai RM, Geleijns J, Veldkamp WJ, Kroft LJ (2008) Clinical evaluation of 64-slice CT assessment of global left ventricular function using automated cardiac phase selection. Circ J 72:641–646CrossRefPubMed
17.
go back to reference Church TS, Levine BD, McGuire DK et al (2007) Coronary artery calcium score, risk factors, and incident coronary heart disease events. Atherosclerosis 190:224–231CrossRefPubMed Church TS, Levine BD, McGuire DK et al (2007) Coronary artery calcium score, risk factors, and incident coronary heart disease events. Atherosclerosis 190:224–231CrossRefPubMed
18.
go back to reference 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 115:402–426CrossRefPubMed 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 115:402–426CrossRefPubMed
19.
go back to reference Hoffmann U, Bamberg F, Chae CU et al (2009) Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infarction using Computer Assisted Tomography) trial. J Am Coll Cardiol 53:1642–1650CrossRefPubMed Hoffmann U, Bamberg F, Chae CU et al (2009) Coronary computed tomography angiography for early triage of patients with acute chest pain: the ROMICAT (Rule Out Myocardial Infarction using Computer Assisted Tomography) trial. J Am Coll Cardiol 53:1642–1650CrossRefPubMed
20.
go back to reference Dawber TR, Kannel WB, Lyell LP (1963) An approach to longitudinal studies in a community: the Framingham Study. Ann New York Acad Sci 107:539–556CrossRef Dawber TR, Kannel WB, Lyell LP (1963) An approach to longitudinal studies in a community: the Framingham Study. Ann New York Acad Sci 107:539–556CrossRef
21.
go back to reference Fuster V, Topol EJ, Nabel EG (2004) Atherothrombosis and coronary artery disease. Lippincott Williams & Wilkins, Philadelphia Fuster V, Topol EJ, Nabel EG (2004) Atherothrombosis and coronary artery disease. Lippincott Williams & Wilkins, Philadelphia
22.
go back to reference Juergens KU, Fischbach R (2006) Left ventricular function studied with MDCT. Eur Radiol 16:342–357CrossRefPubMed Juergens KU, Fischbach R (2006) Left ventricular function studied with MDCT. Eur Radiol 16:342–357CrossRefPubMed
23.
go back to reference Mahnken AH, Muhlenbruch G, Koos R et al (2006) Automated vs. manual assessment of left ventricular function in cardiac multidetector row computed tomography: comparison with magnetic resonance imaging. Eur Radiol 16:1416–1423CrossRefPubMed Mahnken AH, Muhlenbruch G, Koos R et al (2006) Automated vs. manual assessment of left ventricular function in cardiac multidetector row computed tomography: comparison with magnetic resonance imaging. Eur Radiol 16:1416–1423CrossRefPubMed
24.
go back to reference Wiese TH, Rogalla P, Taupitz M et al (2004) Assessment of left ventricular volumes and function: intraindividual comparison of multi-slice spiral CT and electron beam CT in an animal model. Acta Radiol 45:819–827CrossRefPubMed Wiese TH, Rogalla P, Taupitz M et al (2004) Assessment of left ventricular volumes and function: intraindividual comparison of multi-slice spiral CT and electron beam CT in an animal model. Acta Radiol 45:819–827CrossRefPubMed
25.
go back to reference Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114:345–352PubMed Koren MJ, Devereux RB, Casale PN, Savage DD, Laragh JH (1991) Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 114:345–352PubMed
26.
go back to reference Woo P, Mao S, Wang S, Detrano RC (1997) Left ventricular size determined by electron beam computed tomography predicts significant coronary artery disease and events. Am J Cardiol 79:1236–1238CrossRefPubMed Woo P, Mao S, Wang S, Detrano RC (1997) Left ventricular size determined by electron beam computed tomography predicts significant coronary artery disease and events. Am J Cardiol 79:1236–1238CrossRefPubMed
27.
go back to reference Nolan J, Batin PD, Andrews R et al (1998) Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation 98:1510–1516PubMed Nolan J, Batin PD, Andrews R et al (1998) Prospective study of heart rate variability and mortality in chronic heart failure: results of the United Kingdom heart failure evaluation and assessment of risk trial (UK-heart). Circulation 98:1510–1516PubMed
28.
go back to reference Lu MT, Cai T, Ersoy H et al (2009) Comparison of ECG-gated versus non-gated CT ventricular measurements in thirty patients with acute pulmonary embolism. Int J Cardiovascul Imaging 25:101–107CrossRef Lu MT, Cai T, Ersoy H et al (2009) Comparison of ECG-gated versus non-gated CT ventricular measurements in thirty patients with acute pulmonary embolism. Int J Cardiovascul Imaging 25:101–107CrossRef
29.
go back to reference Quiroz R, Kucher N, Schoepf UJ et al (2004) Right ventricular enlargement on chest computed tomography: prognostic role in acute pulmonary embolism. Circulation 109:2401–2404CrossRefPubMed Quiroz R, Kucher N, Schoepf UJ et al (2004) Right ventricular enlargement on chest computed tomography: prognostic role in acute pulmonary embolism. Circulation 109:2401–2404CrossRefPubMed
Metadata
Title
Simple area-based measurement for multidetector computed tomography to predict left ventricular size
Authors
Christopher L. Schlett
Dylan C. Kwait
Amir A. Mahabadi
Fabian Bamberg
Christopher J. O’Donnell
Caroline S. Fox
Udo Hoffmann
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1720-z

Other articles of this Issue 7/2010

European Radiology 7/2010 Go to the issue