Incremental prognostic value of left ventricular function analysis over non-invasive coronary angiography with...

Area of Science:

• Cardiovascular imaging
• Cardiac diagnostics
• Prognostic biomarkers

Background:

• Coronary artery disease (CAD) assessment traditionally relies on anatomical stenosis detection.
• Left ventricular (LV) function is a crucial determinant of cardiac health and patient outcomes.
• The prognostic value of LV function derived from computed tomography coronary angiography (CTA) requires further investigation.

Purpose of the Study:

• To evaluate the prognostic significance of LV function parameters obtained via CTA.
• To determine if LV function analysis offers incremental prognostic value beyond significant stenosis detection using CTA.

Main Methods:

• 728 patients with suspected or known CAD underwent CTA.
• CTA was used to assess significant stenosis (≥50%) and LV function (LV end-diastolic volume, LV end-systolic volume, LV ejection fraction).
• A composite endpoint of mortality, myocardial infarction, and unstable angina was used to assess outcomes.

Main Results:

• Significant stenosis was detected in 30% of patients.
• LV ejection fraction (LVEF) < 49% and LV end-systolic volume (LVESV) > 90 mL were identified as independent predictors of adverse events.
• LV function parameters demonstrated incremental prognostic value over clinical risk factors and CTA-derived stenosis.

Conclusions:

• LV function analysis using CTA provides independent prognostic information in patients with CAD.
• CTA-derived LV function assessment enhances risk stratification beyond traditional anatomical evaluation.