Use of Advanced CT Technology to Evaluate Left Atrial Indices in Patients with a High Heart Rate or with Heart Rate Variability: The Converge Registry

Lavanya Cherukuri, Divya Birudaraju, April Kinninger, Bhanu T. Chaganti, Sivakrishna Pidikiti, Ryan G. Pozon, Anne Concepcion G. Pozon, Suvasini Lakshmanan, Suraj Dahal, Sajad Hamal, Ferdinand Flores, Dialing Christopher, Daniele Andreini, Gianluca Pontone, Edoardo Conte, Rine Nakanishi, Rachael O'Rourke, Christian Hamilton-Craig, Khurram Nasir, Sion K. RoySong Shou Mao, Matthew J. Budoff

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)65-69
Number of pages5
JournalJournal of Nuclear Medicine Technology
Volume49
Issue number1
DOIs
StatePublished - Mar 1 2021

Keywords

  • arrhythmia
  • heart rate variability
  • high heart rate
  • left atrial volume
  • motion artifacts

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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