The estimation of left ventricular function using prospective ECG-triggered coronary CT angiography

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Coronary computed tomography angiography (CCTA) is essential for diagnosing coronary artery disease.
• Prospective ECG-triggered acquisition in CCTA minimizes radiation but can limit left ventricular (LV) ejection fraction (EF) evaluation.

Purpose of the Study:

• To assess the feasibility and utility of LVEF_100msec, a novel index for estimating LV function.
• To evaluate LV function using volumetric changes within a 100 msec window of systole.

Main Methods:

• Retrospective analysis of 271 patients undergoing prospective ECG-triggered CCTA with systolic acquisition.
• Calculation of LVEF_100msec using maximum and minimum LV volumes at specific phases post-QRS.
• Classification of patients into normal, mild-moderately reduced, or severely reduced LV function categories based on a reference test.

Main Results:

• LVEF_100msec values significantly differed across LV function categories (p < 0.001).
• The optimal cutoff value of LVEF_100msec for predicting severe LV dysfunction was 4.3% (AUC 0.924, sensitivity 88%, specificity 89%).

Conclusions:

• LVEF_100msec demonstrates potential as a valuable indicator for severe left ventricular dysfunction.
• This novel index may improve LV function assessment in CCTA studies with reduced radiation exposure.