Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality: results from 7758 patients in the prospective multinational CONFIRM observational cohort study

Arsanjani R, Berman DS, Gransar H, Cheng VY, Dunning A, Lin FY, Achenbach S, Al-Mallah M, Budoff MJ, Callister TQ, Chang HJ, Cademartiri F, Chinnaiyan KM, Chow BJW, Delago A, Hadamitzky M, Hausleiter J, Kaufmann P, Labounty TM, Leipsic J, Raff G, Shaw LJ, Villines TC, Cury RC, Feuchtner G, Kim YJ, Min JK (2014)

Publication Type: Journal article

Publication year: 2014

Journal

Publisher: Radiological Society of North America (RSNA)

Book Volume: 273

Pages Range: 70-7

Journal Issue: 1

DOI: 10.1148/radiol.14122816

Abstract

To assess whether gradations of left ventricular (LV) ejection fraction (LVEF) and volumes measured with coronary computed tomography (CT) would augment risk stratification and discrimination for incident mortality.This study was approved by the institutional review board, and informed consent was obtained when required. Subjects without known coronary artery disease (CAD) who underwent cardiac CT angiography with quantitative LV measurements were categorized according to LVEF (>= 55%, 45%-54.9%, 35%-44.9%, or <35%). LV end-systolic volume (LVESV) and LV end-diastolic volume (LVEDV) were classified as normal (>= 90 mL) or abnormal (>= 200 mL). CAD extent and severity was categorized as none, nonobstructive, obstructive (>= 50%), one-vessel, two-vessel, and three-vessel or left main disease. LVEF and volumes were assessed for risk prediction and discrimination of future mortality by using Cox hazards model and receiver operating characteristic curve analysis, respectively.During a follow-up of 2.0 years ± 0.9, 7758 patients (mean age, 58.5 years ± 13.0; 4220 male patients [54.4%]) were studied. At multivariable analysis, worsening LVEF was independently associated with mortality for moderately (hazard ratio = 3.14, P < .001) and severely (hazard ratio = 5.19, P < .001) abnormal ejection fraction. LVEF demonstrated improved discrimination for mortality (Az = 0.816) when compared with CAD risk factors alone (Az = 0.781) or CAD risk factors plus extent and severity. At multivariable analysis of a subgroup of 3706 individuals, abnormal LVEDV (hazard ratio = 4.02) and LVESV (hazard ratio = 6.46) helped predict mortality (P < .001). Similarly, LVESV and LVEDV demonstrated improved discrimination when compared with CAD risk factors or CAD extent and severity (P < .05).LV dysfunction and volumes measured with cardiac CT angiography augment risk prediction and discrimination for future mortality.

Authors with CRIS profile

Involved external institutions

Cedars-Sinai Medical Center United States (USA) (US) Oklahoma Heart Institute United States (USA) (US) Cornell University United States (USA) (US) Wayne State University (WSU) United States (USA) (US) Harbor–UCLA Medical Center United States (USA) (US) Tennessee Heart & Vascular United States (USA) (US) Yonsei University Health System (YUHS) Korea, Republic of (KR) Azienda Ospedaliero-Universitaria di Parma / Parma University Hospital Italy (IT) Beaumont Health System United States (USA) (US) University of Ottawa Canada (CA) Deutsches Herzzentrum München Germany (DE) Universitätsspital Zürich (USZ) Switzerland (CH) University of British Columbia Canada (CA) Emory University United States (USA) (US) Walter Reed Army Medical Center (WRAMC) United States (USA) (US) Baptist Health South Florida United States (USA) (US) Seoul National University (SNU) / 서울대학교 Korea, Republic of (KR)

How to cite

APA:

Arsanjani, R., Berman, D.S., Gransar, H., Cheng, V.Y., Dunning, A., Lin, F.Y.,... Min, J.K. (2014). Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality: results from 7758 patients in the prospective multinational CONFIRM observational cohort study. Radiology, 273(1), 70-7. https://dx.doi.org/10.1148/radiol.14122816

MLA:

Arsanjani, Reza, et al. "Left ventricular function and volume with coronary CT angiography improves risk stratification and identification of patients at risk for incident mortality: results from 7758 patients in the prospective multinational CONFIRM observational cohort study." Radiology 273.1 (2014): 70-7.

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