Catherine Gebhard1, Ronny R Buechel1, Barbara E Stähli1, Heidi Gransar2, Stephan Achenbach3, Daniel S Berman2, Matthew J Budoff4, Tracy Q Callister5, Benjamin Chow6, Allison Dunning7, Mouaz H Al-Mallah8, Filippo Cademartiri9,10, Kavitha Chinnaiyan11, Ronen Rubinshtein12, Hugo Marques13, Augustin DeLago14, Todd C Villines15, Martin Hadamitzky16, Joerg Hausleiter17, Leslee J Shaw18, Ricardo C Cury19, Gudrun Feuchtner20, Yong-Jin Kim21, Erica Maffei9,10, Gilbert Raff11, Gianluca Pontone22, Daniele Andreini22, Hyuk-Jae Chang23, Jonathon Leipsic24, James K Min25, Philipp A Kaufmann1. 1. Department of Nuclear Medicine, University Hospital, Zurich, Switzerland. 2. Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA. 3. Department of Medicine, University of Erlangen, Erlangen, Germany. 4. Department of Medicine, Harbor UCLA Medical Center, Los Angeles, CA, USA. 5. Tennessee Heart and Vascular Institute, Hendersonville, TN, USA. 6. Department of Medicine and Radiology, University of Ottawa, ON, Canada. 7. Duke Clinical Research Institute, Durham, NC, USA. 8. Department of Medicine, Wayne State University, Henry Ford Hospital, Detroit, MI, USA. 9. Cardiovascular Imaging Unit, Giovanni XXIII Hospital, Monastier, Treviso, Italy. 10. Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands. 11. William Beaumont Hospital, Royal Oaks, MI, USA. 12. Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 13. Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal. 14. Capitol Cardiology Associates, Albany, NY, USA. 15. Department of Medicine, Walter Reed Medical Center, Washington, DC, USA. 16. Division of Cardiology, Deutsches Herzzentrum Munchen, Munich, Germany. 17. Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany. 18. Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. 19. Baptist Cardiac and Vascular Institute, Miami, FL, USA. 20. Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria. 21. Seoul National University Hospital, Seoul, South Korea. 22. Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS, Milan, Italy. 23. Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. 24. Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada. 25. Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
Abstract
BACKGROUND: Left ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender- and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking. METHODS AND RESULTS: 1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 ± 12.4 years, range: 18-92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (>50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 ± 7.7% vs. 64.6 ± 8.1%, P < 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 ± 8.89% vs. 65.50 ± 9.42%, P = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (<40 years) to 95.56 ± 23.17 (>70 years; P < 0.001) and in males from 155.22 ± 35.07 (<40 years) to 130.26 ± 27.18 (>70 years; P < 0.001). CONCLUSION: Our findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Left ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender- and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking. METHODS AND RESULTS: 1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 ± 12.4 years, range: 18-92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (>50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 ± 7.7% vs. 64.6 ± 8.1%, P < 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 ± 8.89% vs. 65.50 ± 9.42%, P = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (<40 years) to 95.56 ± 23.17 (>70 years; P < 0.001) and in males from 155.22 ± 35.07 (<40 years) to 130.26 ± 27.18 (>70 years; P < 0.001). CONCLUSION: Our findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Catherine Gebhard; Monika Maredziak; Michael Messerli; Ronny R Buechel; Fay Lin; Heidi Gransar; Stephan Achenbach; Mouaz H Al-Mallah; Daniele Andreini; Jeroen J Bax; Daniel S Berman; Matthew J Budoff; Filippo Cademartiri; Tracy Q Callister; Hyuk-Jae Chang; Kavitha Chinnaiyan; Benjamin J W Chow; Ricardo C Cury; Augustin DeLago; Gudrun Feuchtner; Martin Hadamitzky; Joerg Hausleiter; Yong-Jin Kim; Jonathon Leipsic; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Gianluca Pontone; Gilbert L Raff; Ronen Rubinshtein; Leslee J Shaw; Todd C Villines; Yao Lu; Erica C Jones; Jessica M Peña; James K Min; Philipp A Kaufmann Journal: Eur Heart J Cardiovasc Imaging Date: 2020-04-01 Impact factor: 6.875
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