Cardiovascular Disease |

A CT Based Measurement of Left Atrial Area Predicts an Echocardiographic Assessment of Left Atrial Volume and Left Ventricular Function in Heart Failure FREE TO VIEW

Amita Kalra, MD; Arang Samim, MD; Amit Kalra, BS; Jacki Deguzman, MD; Belayneh Abejie, MD; Ralph Wessel, MD; Jose Vempilly, MD
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UCSF Fresno, Fresno, CA

Chest. 2013;144(4_MeetingAbstracts):168A. doi:10.1378/chest.1704046
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SESSION TITLE: Cardiovascular Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Echocardiography is widely utilized to assess cardiac chamber size, volume and function. The aim of this study was to determine if computed tomography (CT) can accurately correlate with echocardiographic established measurements in patients with poor acoustic windows or when echocardiography is not readily available.

METHODS: Patients admitted to a teaching hospital with a diagnosis of congestive heart failure (CHF) based on ICD-9 codes who also underwent CT chest and echocardiography within 3 days were identified. Those with co-morbidities according to pre-defined criteria were excluded. A cardiologist blinded to patient information read the echocardiograms and chest CT measurements of cardiac chambers were done under supervision of an academic radiologist. Coronal views on the CT were utilized to measure craniocaudal area of the left atrium (LA). Correlations between radiographic measurements and outcome measurements of LA volume and left ventricular ejection fraction (LVEF) were performed using Pearson’s correlation coefficient. Simple linear regression analysis was performed using SPSS software to detect the direction and magnitude of this correlation. A p-value of <0.05 was considered statistically significant.

RESULTS: Of 70 patients recruited, 47% (33) were female and 53% (37) male with mean age of 57. Mean LVEF calculated on echocardiogram by method of disks was 36.9 ±18.5%. Mean LA volume calculated using the biplane area length method was 90.3±39.8 mL. Mean LA area on CT was 36.1 ± 11.5 cm2. The correlation between LVEF and CT LA area was significant (r=0.24; p=0.04). The correlation between LA volume and craniocaudal area was highly significant (r=0.71; p<0.001).

CONCLUSIONS: CT measurement of cardiac chambers appears to be a reliable predictor of LV function and LA volume in a cohort of patients with CHF.

CLINICAL IMPLICATIONS: When assessing for CHF in patients for whom echocardiography is not feasible, cardiac chamber measurements on CT chest can reliably measure atrial enlargement and cardiac dysfunction using a simple measurement protocol. Often patients present with clinical suggestion of CHF but diagnosis is delayed due to technical limitations of echocardiogram interpretation. When a CT chest is available it can quickly assess LA volume and LVEF in order to prevent delay in treatment.

DISCLOSURE: The following authors have nothing to disclose: Amita Kalra, Arang Samim, Amit Kalra, Jacki Deguzman, Belayneh Abejie, Ralph Wessel, Jose Vempilly

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