Key result
Threshold-based CT excluding papillary muscles and trabeculae yields ~6% higher LVEF versus standard methods.
Why the study?
Deciding whether to include or exclude papillary muscles and trabeculae into the blood pool significantly affects quantification of LV functional parameters and myocardial mass, potentially altering clinical indices for diagnosis and therapy.
Does the inclusion or exclusion of papillary muscles and trabeculae affect left ventricular functional parameters measured via cardiac CT in normal adults?
Observational (n=646)
No
Does the inclusion or exclusion of papillary muscles and trabeculae affect left ventricular functional parameters measured via cardiac CT in normal adults?
Absolute Event Rate: 73.2% vs 67.7%
p-value: p=<0.001
The inclusion or exclusion of papillary muscles and trabeculae significantly affects LV volume and mass measurements on cardiac CT, highlighting the need for consistent methodology during follow-up.
Demands consistent papillary muscle inclusion on CT; leaves open effects on serial monitoring or outcomes.
Abstract Deciding whether to include or exclude the papillary muscles and trabeculae to blood pool is essential, because quantifications of left ventricular (LV) functional parameters and myocardial mass are significantly affected. As a result, such inclusion or exclusion might produce different indices for diagnosis and therapy. Using cardiac CT, we obtained standard values of the portion of papillary muscle and trabeculae in normal adults, and to find out how the inclusion or exclusion of papillary muscle and trabeculae affect LV functional parameters depending on the patient group. Excluding the papillary muscles from the LV mass results in easier automated contour detection using CT. The percentage portions of papillary muscle and trabeculae to LV end-diastolic volume (EDV) and LV mass (LVM) were 11.9 ± 5.6% and 20.2 ± 4.3%, respectively, significantly affecting disease diagnosis. Therefore, imaging should be consistent at follow-up and include or exclude the papillary muscles and trabeculae to avoid introducing significant differences between measurements.
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Kim et al. (2023) conducted an observational in Normal controls, hypertrophic cardiomyopathy, dilated cardiomyopathy, and old myocardial infarction (n=646). Threshold-based blood volume (BV) method vs. Standard (ST) Simpson's method was evaluated on Left ventricular ejection fraction (LVEF) in normal controls (p=<0.001). Excluding papillary muscles and trabeculae from the LV blood pool using the threshold-based CT method significantly increased the measured left ventricular ejection fraction compared to the standard method (73.2% vs 67.7%, p<0.001).
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