Does CTA-derived left ventricular function analysis improve prognostic prediction over anatomic assessment of CAD alone in patients with known or suspected CAD?
CTA-derived left ventricular function analysis (specifically LVEF < 49% and LVESV > 90 mL) provides incremental prognostic value beyond standard anatomic assessment of coronary artery disease.
BACKGROUND: The purpose of this study was to determine the prognostic value of computed tomography coronary angiography (CTA)-derived left ventricular (LV) function analysis and to assess its incremental prognostic value over the detection of significant stenosis using CTA. METHODS: In 728 patients (400 males, mean age 55 ± 12 years) with known or suspected CAD, the presence of significant stenosis (≥ 50% stenosis) and LV function were assessed using CTA. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), and LV ejection fraction (LVEF) were calculated. LV function was assessed as a continuous variable and using cutoff values (LVEDV > 215 mL, LVESV > 90 mL, LVEF 90 mL were independent predictors of events with an incremental prognostic value over clinical risk factors and CTA. CONCLUSIONS: The present results suggest that LV function analysis provides independent and incremental prognostic information beyond anatomic assessment of CAD using CTA.
Graaf et al. (Thu,) studied this question.