Key result
Cardiac CT-derived left atrial total emptying fraction agreed well with echo for detecting advanced diastolic dysfunction and strongly predicted 3-year cardiac outcomes (HR 8.0; 95% CI 2.2-28.4).
Why the study?
The study aimed to assess agreement between cardiac CT and echocardiography for diagnosing advanced diastolic dysfunction and evaluate the prognostic value of CT-based parameters.
Does cardiac computed tomography assessment of diastolic function agree with echo-Doppler and predict clinical outcomes in patients undergoing both imaging modalities?
Cohort (n=101)
Does cardiac computed tomography assessment of diastolic function agree with echo-Doppler and predict clinical outcomes in patients undergoing both imaging modalities?
CT-derived left atrial total emptying fraction shows good agreement with echo-Doppler for diagnosing advanced diastolic dysfunction and strongly predicts cardiac death and heart failure hospitalization.
Answers are grounded in this paper and cite their sources.
CT LA function detects advanced DD with additive HF prognostic value; leaves open integration with echo pending prospective validation.
OBJECTIVES: We aimed to assess the agreement between cardiac computed tomography (CT) and echo for diagnosing advanced diastolic dysfunction (DD) and to assess the prognostic value of CT-based parameters. METHODS: One hundred one consecutive patients who had both CT and echo-Doppler within 1 month were included. Diastolic function was assessed by CT using a previously validated method, based on left atrial volume changes, and compared with echocardiography grades 0 to 3. Patients were followed up for a combined outcome of cardiac death and hospitalization for heart failure. RESULTS: By operating characteristic curve analysis, the best CT-based parameter for predicting advanced DD based on echo was left atrial total emptying fraction. Left atrial total emptying fraction <36% had sensitivity/specificity of 76%/86%. Agreement between echo and CT for detecting advanced (grades 2/3) DD was substantial (κ = 0.62, P < 0.0001). By Cox multivariate analysis, left atrial total emptying fraction was a powerful independent predictor of outcome at 3 years (hazard ratio, 8.0 [2.2-28.4]; P < 0.0001). CONCLUSIONS: Computed tomography-based assessment of DD has a good agreement with echo-Doppler-based results. Left atrial total emptying fraction seems to have a strong prognostic value.
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Veen et al. (2021) conducted a cohort in diastolic dysfunction (n=101). Cardiac computed tomography (CT) vs. Echo-Doppler was evaluated on combined outcome of cardiac death and hospitalization for heart failure (HR 8.0, 95% CI 2.2-28.4, p=<0.0001). Cardiac CT-derived left atrial total emptying fraction agreed well with echo for detecting advanced diastolic dysfunction and strongly predicted 3-year cardiac outcomes (HR 8.0; 95% CI 2.2-28.4).
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