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Prognostic value of CT-derived left atrial and left ventricular measures in patients with acute chest pain

Richard A P Takx1, Rozemarijn Vliegenthart2, U Joseph Schoepf3

  • 1Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States; Department of Radiology, University Medical Center Utrecht, The Netherlands.

European Journal of Radiology
|December 29, 2016
PubMed

Insights

Left atrial diameter and left ventricular mass, measured by CT angiography, predict major adverse cardiac events (MACE) independently of traditional risk factors. These cardiac imaging parameters offer valuable prognostic information for patients with chest pain.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiovascular Disease

Background:

  • Assessing cardiovascular risk is crucial for patients presenting with chest pain.
  • Traditional risk factors and coronary artery disease (CAD) severity are key prognostic indicators.
  • Novel imaging biomarkers may enhance risk stratification.

Purpose of the Study:

  • To identify left atrial (LA) and left ventricular (LV) parameters associated with future major adverse cardiac events (MACE).
  • To determine if these LA and LV parameters provide prognostic value independent of established risk factors and CT-derived CAD measures.

Main Methods:

  • Retrospective analysis of patients undergoing coronary CT angiography (CCTA) for acute chest pain.
  • Measurement of LV mass, LV ejection fraction (EF), LA diameter, and other cardiac chamber dimensions.
  • Cox proportional hazard analysis to assess the association between CT measures and MACE occurrence.

Main Results:

  • In 225 patients, 42 (18.7%) experienced MACE over 13 months median follow-up.
  • Increased LA diameter and LV mass were significant predictors of MACE, independent of Framingham risk score.
  • LA diameter and LV mass showed prognostic value independent of each other.

Conclusions:

  • CT-derived LA diameter and LV mass are associated with future MACE in patients evaluated for chest pain.
  • These parameters offer independent prognostic value beyond traditional risk factors, coronary calcium score, and obstructive CAD.
Abstract

Keywords:
Cardiovascular eventsComputed tomographyLeft atrial sizeLeft ventricular function

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