Assessment of Left Ventricular Ejection Fraction Using Low Radiation Dose Computed Tomography

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2015 May 24

PMID 26002814

Citations 6

Authors

Yiqi Yang

Yeung Yam

Li Chen

Ahmed Aljizeeri

Siamak Aliyary Ghraboghly

Ibraheem Al-Harbi

Ally Pen

Terrence D Ruddy

Benjamin J W Chow

Affiliations

Soon will be listed here.

Abstract

Background: Cardiac CT is a non-invasive modality with the ability to estimate LVEF. However, given its limited temporal resolution and radiation, there has been initial resistance to use CT to measure LVEF. Developing an accurate, fast, low radiation dose protocol is desirable.

Objective: The objective of this study is to demonstrate that a 'low radiation dose' 64 slice cardiac computed tomography (CT) protocol is feasible and can accurately measure left ventricular ejection fraction (LVEF) while delivering a radiation dose lower than radionuclide angiography (RNA).

Methods: Patients undergoing RNA were prospectively screened and enrolled to undergo a 'low-dose' 64 slice CT LVEF protocol. LVEF measures, duration of each study and radiation dose between CT and RNA were compared.

Results: A total of 77 patients (mean age = 61.8 ± 12.2 years and 58 men) were analyzed. The mean LVEF measured by CT and RNA were 41.9 ± 15.2% and 39.4 ± 13.9%, respectively, (P = 0.154) with a good correlation (r = 0.863). Bland-Altman plot revealed a good agreement between the CT and RNA LVEF (mean difference of -2.4). There was good agreement between CT LVEF and RNA for identifying patients with LVEF ≤30% (kappa = 0.693) and LVEF ≥50% (kappa = 0.749). The mean dose estimated effective dose for CT and RNA were 4.7 ± 1.6 and 9.5 ± 1.0 mSv, respectively. The mean CT LVEF imaging duration (4:32 ± 3:05 minutes) was significantly shorter than the RNA image acquisition time (9:05 ± 2:36 minutes; p < 0.001).

Conclusion: The results of our study suggest that low-dose CT LVEF protocol is feasible, accurate, and fast while delivering a lower radiation dose than traditional RNA.

Citing Articles

Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care.

Lee M, Liu D, Hung S, Yu C, Chi C, Chiou W Front Cardiovasc Med. 2020; 7:16.

PMID: 32154267 PMC: 7047711. DOI: 10.3389/fcvm.2020.00016.

Sex Differences in Associations of Arterial Compliance With Coronary Artery Plaque and Calcification Burden.

Coutinho T, Yam Y, Chow B, Dwivedi G, Inacio J J Am Heart Assoc. 2017; 6(8).

PMID: 28862955 PMC: 5586449. DOI: 10.1161/JAHA.117.006079.

Review of Cardiovascular Imaging in the Journal of Nuclear Cardiology in 2016. Part 1 of 2: Positron Emission Tomography, Computed Tomography and Magnetic Resonance.

AlJaroudi W, Hage F J Nucl Cardiol. 2017; 24(2):649-656.

PMID: 28194727 DOI: 10.1007/s12350-017-0820-4.

Comparison of left ventricular ejection fraction values obtained using invasive contrast left ventriculography, two-dimensional echocardiography, and gated single-photon emission computed tomography.

Garg N, Dresser T, Aggarwal K, Gupta V, Mittal M, Alpert M SAGE Open Med. 2016; 4:2050312116655940.

PMID: 27621804 PMC: 5006806. DOI: 10.1177/2050312116655940.

Role of cardiovascular imaging in selection of donor hearts.

Nair N, Gongora E World J Transplant. 2016; 5(4):348-53.

PMID: 26722663 PMC: 4689946. DOI: 10.5500/wjt.v5.i4.348.

References

Butler J, Shapiro M, Jassal D, Jassal D, Neilan T, Neilan T . Comparison of multidetector computed tomography and two-dimensional transthoracic echocardiography for left ventricular assessment in patients with heart failure. Am J Cardiol. 2007; 99(2):247-9. DOI: 10.1016/j.amjcard.2006.08.021. View

White H, Norris R, Brown M, Brandt P, Whitlock R, Wild C . Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987; 76(1):44-51. DOI: 10.1161/01.cir.76.1.44. View

Dewey M, Muller M, Eddicks S, Schnapauff D, Teige F, Rutsch W . Evaluation of global and regional left ventricular function with 16-slice computed tomography, biplane cineventriculography, and two-dimensional transthoracic echocardiography: comparison with magnetic resonance imaging. J Am Coll Cardiol. 2006; 48(10):2034-44. DOI: 10.1016/j.jacc.2006.04.104. View

. Updated imaging guidelines for nuclear cardiology procedures, part 1. J Nucl Cardiol. 2001; 8(1):G5-G58. DOI: 10.1067/mnc.2001.112538. View

Taylor G, HUMPHRIES J, Mellits E, Pitt B, Schulze R, Griffith L . Predictors of clinical course, coronary anatomy and left ventricular function after recovery from acute myocardial infarction. Circulation. 1980; 62(5):960-70. DOI: 10.1161/01.cir.62.5.960. View

Russo A, Stainback R, Bailey S, Epstein A, Heidenreich P, Jessup M . ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 appropriate use criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy: a report of the American College of Cardiology Foundation appropriate use criteria task force,.... J Am Coll Cardiol. 2013; 61(12):1318-68. DOI: 10.1016/j.jacc.2012.12.017. View

McDonald R, McDonald J, Carter R, Hartman R, Katzberg R, Kallmes D . Intravenous contrast material exposure is not an independent risk factor for dialysis or mortality. Radiology. 2014; 273(3):714-25. DOI: 10.1148/radiol.14132418. View

Chow B, Wells G, Chen L, Yam Y, Galiwango P, Abraham A . Prognostic value of 64-slice cardiac computed tomography severity of coronary artery disease, coronary atherosclerosis, and left ventricular ejection fraction. J Am Coll Cardiol. 2010; 55(10):1017-28. DOI: 10.1016/j.jacc.2009.10.039. View

Sanz G, Castaner A, Betriu A, Magrina J, Roig E, Coll S . Determinants of prognosis in survivors of myocardial infarction: a prospective clinical angiographic study. N Engl J Med. 1982; 306(18):1065-70. DOI: 10.1056/NEJM198205063061801. View

10.

Schuijf J, Bax J, Jukema J, Lamb H, Salm L, de Roos A . Assessment of left ventricular volumes and ejection fraction with 16-slice multi-slice computed tomography; comparison with 2D-echocardiography. Int J Cardiol. 2006; 116(2):201-5. DOI: 10.1016/j.ijcard.2006.04.040. View

11.

Chow B, Abunassar J, Ascah K, DeKemp R, DaSilva J, Mesana T . Effects of mitral valve surgery on myocardial energetics in patients with severe mitral regurgitation. Circ Cardiovasc Imaging. 2010; 3(3):308-13. DOI: 10.1161/CIRCIMAGING.109.859843. View

12.

Kim I, Choo K, Lee J, Kim S, Kim J, Kim Y . Comparison of gated blood pool SPECT and multi-detector row computed tomography for measurements of left ventricular volumes and ejection fraction in patients with atypical chest pain: validation with radionuclide ventriculography. Cardiology. 2006; 107(1):8-16. DOI: 10.1159/000093608. View

13.

Strickberger S, Benson D, Biaggioni I, Callans D, Cohen M, Ellenbogen K . AHA/ACCF scientific statement on the evaluation of syncope: from the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research.... J Am Coll Cardiol. 2006; 47(2):473-84. DOI: 10.1016/j.jacc.2005.12.019. View

14.

Hunt S . ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001.... J Am Coll Cardiol. 2005; 46(6):e1-82. DOI: 10.1016/j.jacc.2005.08.022. View

15.

Zipes D, Borggrefe M, Buxton A, Chaitman B, Fromer M, Gregoratos G . ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of.... J Am Coll Cardiol. 2006; 48(5):e247-346. DOI: 10.1016/j.jacc.2006.07.010. View

16.

Chow B, Abraham A, Wells G, Chen L, Ruddy T, Yam Y . Diagnostic accuracy and impact of computed tomographic coronary angiography on utilization of invasive coronary angiography. Circ Cardiovasc Imaging. 2009; 2(1):16-23. DOI: 10.1161/CIRCIMAGING.108.792572. View

17.

Beck-da-Silva L, de Bold A, Davies R, Chow B, Ruddy T, Fraser M . Effect of bisoprolol on right ventricular function and brain natriuretic peptide in patients with heart failure. Congest Heart Fail. 2004; 10(3):127-32. DOI: 10.1111/j.1527-5299.2004.03316.x. View

18.

Eagle K, Guyton R, Davidoff R, Edwards F, Ewy G, Gardner T . ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for.... J Am Coll Cardiol. 2004; 44(5):e213-310. DOI: 10.1016/j.jacc.2004.07.021. View

19.

Massardo T, Gal R, Grenier R, Schmidt D, Port S . Left ventricular volume calculation using a count-based ratio method applied to multigated radionuclide angiography. J Nucl Med. 1990; 31(4):450-6. View

20.

Lin F, Devereux R, Roman M, Meng J, Jow V, Jacobs A . Cardiac chamber volumes, function, and mass as determined by 64-multidetector row computed tomography: mean values among healthy adults free of hypertension and obesity. JACC Cardiovasc Imaging. 2009; 1(6):782-6. DOI: 10.1016/j.jcmg.2008.04.015. View