Key result
An LVEF 100msec ≤6.3% derived from prospective ECG-triggered cardiac CT was an independent predictor of major adverse cardiovascular events (HR 3.758; 95% CI 1.543-9.148; p=0.004).
Why the study?
Prospective ECG-triggered cardiac CT limits assessment of LV ejection fraction, and the prognostic value of a new LVEF 100msec index was unknown.
Does LVEF 100msec derived from prospective ECG-triggered cardiac CT predict MACE in patients undergoing cardiac CT?
Cohort (n=313)
Does LVEF 100msec derived from prospective ECG-triggered cardiac CT predict MACE in patients undergoing cardiac CT?
Answers are grounded in this paper and cite their sources.
LVEF 100msec derived from prospective ECG-triggered cardiac CT is an independent predictor of MACE, providing a novel prognostic marker without additional radiation.
Background Prospective ECG-triggered cardiac computed tomography (CT) imaging limits the ability to assess left ventricular (LV) ejection fraction (EF). We previously developed a new index derived from LV volume changes over 100 ms during systole (LVEF 100msec ) as a surrogate of LV function in patients undergoing prospective ECG-triggered cardiac CT. We sought to evaluate the prognostic value of LVEF 100msec . Methods Patients undergoing prospective systolic ECG-triggered cardiac CT were enrolled between January 2015 and September 2022. Each CT was analyzed for LVEF 100msec . Area under the curve analysis and Cox proportional hazards models were used to define the best LVEF 100msec cut-off and to predict major adverse cardiovascular events (MACE), defined as a composite of all-cause death, cardiac death/arrest, non-fatal myocardial infarction, and stroke. Results The study enrolled 313 patients (median age = 58 years, male = 52.4 %). During a median follow-up of 924 (660–1365) days, 24 (7.7 %) patients had MACE. LVEF 100msec was significantly lower in the MACE group compared to the non-MACE group (4.8 % vs. 8.3 %, p = 0.002). Optimal LVEF 100msec cut-off for predicting MACE was 6.3 %. MACE-free survival rate was significantly lower in patients with LVEF 100msec ≤6.3 % than those with >6.3 % (p < 0.001). LVEF 100msec ≤6.3 % was an independent predictor of MACE, with an adjusted hazard ratio of 3.758 (95 % CI, 1.543–9.148; p = 0.004). The prognostic value of LVEF 100msec was consistent across the various severities of coronary artery disease. Conclusion LVEF 100msec was an independent predictor of adverse events. The implementation of LVEF 100msec may improve the prognostic value of prospective ECG-triggered cardiac CT.
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Kadoya et al. (2024) conducted a cohort in Patients undergoing prospective ECG-triggered cardiac CT (n=313). LVEF 100msec ≤6.3% vs. LVEF 100msec >6.3% was evaluated on Major adverse cardiovascular events (MACE), defined as a composite of all-cause death, cardiac death/arrest, non-fatal myocardial infarction, and stroke (HR 3.758, 95% CI 1.543-9.148, p=0.004). An LVEF 100msec ≤6.3% derived from prospective ECG-triggered cardiac CT was an independent predictor of major adverse cardiovascular events (HR 3.758; 95% CI 1.543-9.148; p=0.004).
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