Extracellular Volume Fraction Analysis on Cardiac Computed Tomography Is Useful for Predicting the Prognosis of...

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Extracellular volume fraction (ECV) analysis using computed tomography (CT) is a novel technique.
• Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition requiring accurate prognostic markers.
• Assessing cardiac structure and function is crucial for managing HCM patients.

Purpose of the Study:

• To evaluate the utility of CT-derived ECV in predicting major adverse cardiac events (MACE) in patients with HCM.
• To establish a correlation between left ventricular ECV (LV-ECV) and adverse outcomes in HCM.
• To determine the prognostic value of LV-ECV compared to other cardiac parameters.

Main Methods:

• Retrospective analysis of cardiac CT scans from 101 HCM patients (January 2009 - December 2021).
• Measurement of left ventricular ECV (LV-ECV) using CT.
• Statistical analysis including Cox proportional hazards model and receiver operating characteristic (ROC) analysis to assess MACE prediction.

Main Results:

• Fifteen percent of HCM patients experienced MACE.
• Patients with MACE exhibited significantly higher LV-ECV, left atrial diameter, LV end-systolic diameter, and lower ejection fraction (LVEF).
• LV-ECV (≥37.6%) and LVEF were significant independent predictors of MACE; an LV-ECV threshold of 37.6% identified higher MACE risk.

Conclusions:

• CT-derived ECV analysis demonstrates significant potential for predicting MACE in HCM patients.
• LV-ECV serves as a valuable prognostic biomarker in HCM, complementing traditional assessments.
• This imaging biomarker may aid in risk stratification and personalized treatment strategies for HCM.