Detection of left ventricular dysfunction on axial non-contrast chest CT

To evaluate the performance of axial non-contrast CT images in detecting systolic and diastolic left ventricular (LV) dysfunction.

This single-center retrospective study assessed 178 participants who underwent transthoracic ultrasonography and had non-contrast chest CT data within three months of ultrasonography. The patients were divided into LV systolic dysfunction (<52% ejection fraction in men and <54% in women), LV diastolic dysfunction (at least three of the following four criteria were met: average E/e' ratio >14; septal e' <7 cm/s or lateral e' <10 cm/s; peak tricuspid regurgitation velocity >2.8 m/s; or left atrial maximum volume index >34 ml/m²), and normal LV function groups. CT parameters were evaluated as predictive factors for LV dysfunction. These parameters were: I, maximum minor axis diameter of the LV lumen; II, I plus myocardial wall thickness; III, maximum left atrium anteroposterior diameter; IV, maximum transverse cardiac diameter; V, myocardial wall thickness; I-IV divided by maximum medial thoracic diameter; and I-IV divided by anteroposterior thoracic diameter. All parameters were measured on axial images: diameters were maximized.

LV systolic dysfunction was indicated when parameter IV exceeded 131.2 mm with sensitivity and specificity of 71.8% and 77.0%, respectively. Moreover, LV diastolic dysfunction was indicated when parameter III divided by anteroposterior thoracic diameter exceeded 0.165 with sensitivity and specificity of 77.8% and 83.0%, respectively.

Axial non-contrast chest CT is useful for detecting LV dysfunction. Even CT scans for other purposes provide LV function information that may lead to appropriate examination.