Why the study?
Atrial size predicts cardiovascular mortality and non-ECG-gated CTPA is commonly used for cardiopulmonary evaluation, but normative values for biatrial volumes are lacking.
Does non-ECG-gated CTPA accurately measure biatrial volumes compared to TTE in patients with normal diastology?
Does non-ECG-gated CTPA accurately measure biatrial volumes compared to TTE in patients with normal diastology?
Non-ECG-gated CTPA provides easy and reproducible biatrial volumetric assessments, though TTE tends to underestimate these volumes compared to CTPA.
Answers are grounded in this paper and cite their sources.
TTE biatrial volumes may be underestimated versus CTPA; leaves open validation of non-gated CTPA for clinical use.
Atrial size is a predictor of cardiovascular mortality. Non-ECG-gated computed tomography pulmonary angiography (CTPA) is a common test for cardiopulmonary evaluation but normative values for biatrial volumes are lacking. We derived normal CT biatrial volumes using manual and semiautomated segmentation with contemporaneous transthoracic echocardiography (TTE) to confirm normal diastology. Thirty-five consecutive cases in sinus rhythm with no history of cardio-vascular, renal, or pulmonary disease and normal diastolic function were selected. Planimetric CTPA measurements were compared to TTE volumes measured using area length method. TTE and CTPA derived normal LAVi and RAVi were 27 + 5 and 20 + 6 mL/m2, and 30 + 8 and 29 + 9 mL/m2, respectively. Bland–Altman analysis revealed an underestimation of biatrial volumes by TTE. TTE-CT mean biases for LAV and RAV were −5.7 + 12.0 mL and −16.2 + 14.8 mL, respectively. The CT intraclass correlation coefficients (ICC 95% CI) for LA and RA volumes were 0.99 (0.96–1.00) and 0.96 (0.76–0.99), respectively. There was excellent correlation (p < 0.001) between the semiautomated and manual measurements for LA (r 0.99, 95% CI 0.98–0.99) and RA (r 0.99, 95% CI 0.99–1.00). Atrial volumetric assessment on CTPA is easy and reproducible and can provide additional metric in cardiopulmonary assessment.
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Gopalan et al. (2022) studied this question.
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