TY - JOUR
T1 - Use of Advanced CT Technology to Evaluate Left Atrial Indices in Patients with a High Heart Rate or with Heart Rate Variability
T2 - The Converge Registry
AU - Cherukuri, Lavanya
AU - Birudaraju, Divya
AU - Kinninger, April
AU - Chaganti, Bhanu T.
AU - Pidikiti, Sivakrishna
AU - Pozon, Ryan G.
AU - Pozon, Anne Concepcion G.
AU - Lakshmanan, Suvasini
AU - Dahal, Suraj
AU - Hamal, Sajad
AU - Flores, Ferdinand
AU - Christopher, Dialing
AU - Andreini, Daniele
AU - Pontone, Gianluca
AU - Conte, Edoardo
AU - Nakanishi, Rine
AU - O'Rourke, Rachael
AU - Hamilton-Craig, Christian
AU - Nasir, Khurram
AU - Roy, Sion K.
AU - Mao, Song Shou
AU - Budoff, Matthew J.
N1 - Funding Information:
Matthew Budoff performs work for the National Institutes of Health and GE Healthcare. The study was funded by GE Healthcare. No other potential conflict of interest relevant to this article was reported.
Publisher Copyright:
COPYRIGHT © 2021 by the Society of Nuclear Medicine and Molecular Imaging
PY - 2021/3/1
Y1 - 2021/3/1
N2 - We intended to assess the ability of current-generation 256-slice coronary CT angiography (CCTA) to measure left atrial volume (LAV), comparing patients with a high heart rate (HiHR) of at least 70 bpm and patients with heart rate variability such as atrial fibrillation (AFib). Methods: Using the prospective Converge Registry of patients undergoing 256-detector CCTA on a Revolution scanner, we enrolled 121 HiHR patients (74 men; mean age, 62.7 ± 12.5 y) and 102 AFib patients (72 men; mean age, 60.5 ± 11.0 y) after obtaining informed consent. Quantitative data analysis of LAV was performed using automated methods, and end-systolic phases were chosen for measurements from CCTA. A Student t test, Wilcoxon rank-sum test, or χ2 test assessed baseline parameters. Univariate and multivariate linear regression analysis was used to assess LAV and LAV index (LAVI) while adjusting potentially confounding variables. Results: Mean LAV was significantly higher in AFib subjects (148.6 ± 57.2 mL) than in HiHR subjects (102.1 ± 36.5 mL) (P, 0.0001). Similarly, mean LAVI was significantly higher in AFib subjects (72.4 ± 28.1 mL/m2) than in HiHR subjects (51.5 ± 19.0 mL/m2) (P, 0.0001). After adjusting for age, body mass index, sex, diabetes, hypertension, hyperlipidemia, and smoking, subjects with AFib had, on average, LAV measures higher by 41.2 ± 6.7 mL and LAVI values higher by 23.1 ± 3.4 mL/m2 (P, 0.0001). Conclusion: Misalignment and motion artifacts in CCTA images affect diagnostic CT performance, especially in patients with elevated heart rates or profound arrhythmia. However, the new-generation Revolution CCTA provides detailed information on left-atrium-complex morphology and function, in addition to coronary anatomy, in HiHR and AFib patients without additional radiation, scanning, or contrast requirements.
AB - We intended to assess the ability of current-generation 256-slice coronary CT angiography (CCTA) to measure left atrial volume (LAV), comparing patients with a high heart rate (HiHR) of at least 70 bpm and patients with heart rate variability such as atrial fibrillation (AFib). Methods: Using the prospective Converge Registry of patients undergoing 256-detector CCTA on a Revolution scanner, we enrolled 121 HiHR patients (74 men; mean age, 62.7 ± 12.5 y) and 102 AFib patients (72 men; mean age, 60.5 ± 11.0 y) after obtaining informed consent. Quantitative data analysis of LAV was performed using automated methods, and end-systolic phases were chosen for measurements from CCTA. A Student t test, Wilcoxon rank-sum test, or χ2 test assessed baseline parameters. Univariate and multivariate linear regression analysis was used to assess LAV and LAV index (LAVI) while adjusting potentially confounding variables. Results: Mean LAV was significantly higher in AFib subjects (148.6 ± 57.2 mL) than in HiHR subjects (102.1 ± 36.5 mL) (P, 0.0001). Similarly, mean LAVI was significantly higher in AFib subjects (72.4 ± 28.1 mL/m2) than in HiHR subjects (51.5 ± 19.0 mL/m2) (P, 0.0001). After adjusting for age, body mass index, sex, diabetes, hypertension, hyperlipidemia, and smoking, subjects with AFib had, on average, LAV measures higher by 41.2 ± 6.7 mL and LAVI values higher by 23.1 ± 3.4 mL/m2 (P, 0.0001). Conclusion: Misalignment and motion artifacts in CCTA images affect diagnostic CT performance, especially in patients with elevated heart rates or profound arrhythmia. However, the new-generation Revolution CCTA provides detailed information on left-atrium-complex morphology and function, in addition to coronary anatomy, in HiHR and AFib patients without additional radiation, scanning, or contrast requirements.
KW - arrhythmia
KW - heart rate variability
KW - high heart rate
KW - left atrial volume
KW - motion artifacts
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U2 - 10.2967/jnmt.120.253781
DO - 10.2967/jnmt.120.253781
M3 - Article
C2 - 33219160
AN - SCOPUS:85102602590
VL - 49
SP - 65
EP - 69
JO - Journal of Nuclear Medicine Technology
JF - Journal of Nuclear Medicine Technology
SN - 0091-4916
IS - 1
ER -