Korean J Radiol.  2017 ;18(4):664-673. 10.3348/kjr.2017.18.4.664.

Left Ventricular Functional Parameters and Geometric Patterns in Korean Adults on Coronary CT Angiography with a 320-Detector-Row CT Scanner

Affiliations
  • 1Department of Radiology, College of Medicine, Dong-A University, Busan 49201, Korea.
  • 2Department of Cardiology, College of Medicine, Dong-A University, Busan 49201, Korea.
  • 3Department of Radiology, Kyungpook National University, Daegu 41944, Korea. jonglee@knu.ac.kr

Abstract


OBJECTIVE
To assess the normal reference values of left ventricle (LV) functional parameters in Korean adults on coronary CT angiography (CCTA) with a 320-detector-row CT scanner, and to analyze sex-related differences and correlations with various clinical characteristics.
MATERIALS AND METHODS
This study retrospectively enrolled 172 subjects (107 men and 65 women; age, 58 ± 10.9 years; body surface area [BSA], 1.75 ± 0.2 m²) who underwent CCTA without any prior history of cardiac disease. The following parameters were measured by post-processing the CT data: LV volume, LV functional parameters (ejection fraction, stroke volume, cardiac output, etc.), LV myocardial mass, LV inner diameter, and LV myocardial thickness (including septal wall thickness [SWT], posterior wall thickness [PWT], and relative wall thickness [RWT = 2 × PWT / LV inner diameter]). All of the functional or volumetric parameters were normalized using the BSA. The general characteristics and co-morbidities for the enrolled subjects were recorded, and the correlations between these factors and the LV parameters were then evaluated.
RESULTS
The LV myocardial thickness (SWT, 1.08 ± 0.18 cm vs. 0.90 ± 0.17 cm, p < 0.001; PWT, 0.91 ± 0.15 cm vs. 0.78 ± 0.10 cm, p < 0.001; RWT, 0.38 ± 0.08 cm vs. 0.33 ± 0.05 cm, p < 0.001), LV volume (LV end-diastolic volume, 112.9 ± 26.1 mL vs. 98.2 ± 21.0 mL, p < 0.001; LV end-systolic volume, 41.7 ± 14.7 mL vs. 33.7 ± 12.2 mL, p = 0.001) and mass (145.0 ± 29.1 g vs. 107.9 ± 20.0 g, p < 0.001) were significantly greater in men than in women. However, these differences were not significant after normalization using BSA, except for the LV mass (LV mass index, 79.6 ± 14.0 g/m² vs. 66.2 ± 11.0 g/m², p < 0.001). The cardiac output and ejection fraction were not significantly different between the men and women (cardiac output, 4.3 ± 1.0 L/min vs. 4.2 ± 0.9 L/min, p = 0.452; ejection fraction, 63.4 ± 7.7% vs. 66.4 ± 7.6%, p = 0.079). Most of the LV parameters were positively correlated with BSA, body weight, and total Agatston score.
CONCLUSION
This study provides sex-related reference values and percentiles for LV on cardiac CT and should assist in interpreting results.

Keyword

Computed tomography; Heart; Left ventricle; Normal value; Ventricular function; Ventricular volume; Korean

MeSH Terms

Adult
Aged
Asian Continental Ancestry Group
*Computed Tomography Angiography
Female
Heart Ventricles/*diagnostic imaging
Humans
Male
Middle Aged
Republic of Korea
Retrospective Studies
Stroke Volume
Ventricular Function, Left/*physiology

Figure

  • Fig. 1 Measurements of left ventricular (LV) volume and myocardial mass.LV volumes were automatically calculated based on Hounsfield unit thresholding of volumetric dataset by using data from systolic (A) and diastolic (B) phases. LV myocardial mass was calculated on end-diastolic phase by using LV endocardial and epicardial contours that were semi automatically suggested by software.

  • Fig. 2 Measurements of LV dimension and wall thickness at end-diastolic phase.A. LV inner dimension was measured on 4-chamber MPR at chorda level (black arrow). B. LV wall thickness on septum (SWT, black arrowheads) and posterior wall (PWT, white arrowheads) were measured on short-axis MPR at chorda level. LV = left ventricular, MPR = multiplanar reformation, PWT = posterior wall thickness, SWT = septal wall thickness


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