Assessment of left ventricular function and mass in dual-source computed tomography coronary angiography Influence of beta-blockers on left ventricular function: Comparison to magnetic resonance imaging

作者：Jensen Christoph J^*; Jochims Markus; Hunold Peter; Forsting Michael; Barkhausen Joerg; Sabin Georg V; Bruder Oliver; Schlosser Thomas

来源：European Journal of Radiology, 2010, 74(3): 484-491.

DOI：10.1016/j.ejrad.2009.03.027

• Dual-source computed tomography
• Cardiac magnetic resonance imaging
• Left ventricular function
• Left ventricular mass
• Beta-blockers

Purpose: To quantify left ventricular (LV) function and mass (LVM) derived from dual-source computed tomography (DSCT) and the influence of beta-blocker administration compared to cardiac magnetic resonance imaging (CMR).
Methods: Thirty-two patients undergoing cardiac DSCT and CMR were included, where of fifteen received metoprolol intravenously before DSCT. LV parameters were calculated by the disc-summation method (DSM) and by a segmented region-growing algorithm (RGA). All data sets were analyzed by two blinded observers. Interobserver agreement was tested by the intraclass correlation coefficient.
Results.: 1. Using DSMLV parameters were not statistically different between DSCT and CMR in all patients (DSCT vs. CMR: EF 63 +/- 8% vs. 64 +/- 8%, p = 0.47; EDV 136 +/- 36 ml vs. 138 +/- 35 ml, p = 0.66; ESV 52 +/- 21 ml vs. 52 +/- 22 ml, p = 0.61; SV 83 +/- 22 ml vs. 87 +/- 19 ml, p = 0.22; CO 5.4 +/- 0.9 l/ min vs. 5.7 +/- 1.2 l/ min, p = 0.09, LVM 132 +/- 33 g vs. 132 +/- 33 g, p = 0.99).
2. In a subgroup of 15 patients beta-blockade prior to DSCT resulted in a lower ejection fraction (EF), stroke volume(SV), cardiac output(CO) and increase in end systolic volume(ESV) in DSCT (EF 59 +/- 8% vs. 62 +/- 9%; SV 73 +/- 17 ml vs. 81 +/- 15 ml; CO 5.7 +/- 1.2 l/ min vs. 5.0 +/- 0.8 l/min; ESV 52 +/- 27 ml vs. 57 +/- 24 ml, all p < 0.05).
3. Analyzing the RGA parameters LV volumes were not significantly different compared to DSM, whereas LVM was higher using RGA (177 perpendicular to 31 g vs. 132 perpendicular to 33 g, p < 0.05). Interobserver agreement was excellent comparing DSM values with best agreement between RGA calculations.
Conclusion: Left ventricular volumes and mass can reliably be assessed by DSCT compared to CMR. However, beta-blocker administration leads to statistically significant reduced EF, SV and CO, whereas ESV significantly increases. DSCT RGA reliably analyzes LV function, whereas LVM is overestimated compared to DSM.

• 出版日期2010-6