| Can CT measured LA diameter predict the presence and the degree of LV Diastolic Dysfunction? |
Gae An Kim
, Ji Ung Na
, Dong Hyuk Shin
, Jang Hee Lee
|
| Department of Emergency Medicine, Samsung Kangbuk Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea |
| Correspondence
Jang Hee Lee Tel: +82-2-2001-2488, Fax: +82-2-2001-2891, Email: lemonpianote@gmail.com |
|
Received: January 24, 2024. Revised: April 15, 2024. Accepted: April 19, 2024. Published online: May 23, 2024. |
|
|
| ABSTRACT |
Objective
This study was conducted to determine whether the presence and the degree of left ventricular diastolic dysfunction (LVDD) can be predicted by the simple LA diameter measured on computed tomography (CTLAD).
Methods
Among adult patients who underwent both chest CT and echocardiography in the emergency department from January 2020 to December 2021, a retrospective cross-sectional study was conducted on patients in whom the time interval between the two tests was less than 24 hours. Receiver operating characteristic curve analysis was used to evaluate the diagnostic power of CTLAD for echocardiographic LVDD.
Results
In a study involving 373 patients, 192 (51.5%) had LVDD. Among them, 122 (63.5%) had grade 1, 61 (31.8%) had grade 2, and 9 (4.7%) had ≥grade 3 LVDD. Median CTLAD values were 4.1cm for grade 1, 4.5cm for grade 2, and 4.9cm for ≥grade 3 LVDD. The AUC value of CTLAD in distinguishing LVDD of ≥grade 1, ≥grade 2 (optimal cutoff ≥4.4cm), and ≥grade 3 (optimal cutoff ≥4.5cm) were 0.588, 0.657 (with sensitivity 61.4%, specificity 66.0%, positive predictive value [PPV] 29.5%, negative predictive value [NPV] 88.1%, odds ratio [OR] 3.1), and 0.834 (with sensitivity 88.9%, specificity 70.1%, PPV 6.8%, NPV 99.6%, OR 18.7), respectively.
Conclusion
CTLAD ≥4.4cm can be used as a rough reference value to distinguish LVDD of ≥grade 2, and CTLAD ≥4.5cm can be very reliably distinguish LVDD of ≥grade 3. CTLAD might be very useful parameter in predicting LVDD in environments where echocardiography is not available. |
| Keywords:
Computed Tomography; Echocardiography; Heart Failure, Diastolic; Ventricular Dysfunction, Left; Left Atrium |
|
|
|
PDF Links
Full text via DOI
Download Citation 
