Abstract 10842: Incremental Prognostic Value of Left Ventricular Function Analysis over Non-Invasive Coronary Angiography using Multidetector Computed Tomography
Background: The purpose of this study was to determine the prognostic value of 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 was 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 thresholds (LVEDV > 215 ml, LVESV > 90 ml, LVEF < 49%). The following events were combined in a composite end-point: all-cause mortality, non-fatal myocardial infarction, and unstable angina pectoris requiring hospitalization.
Results: On CTA, a significant stenosis was observed in 221 patients (30%). During follow-up [median 765 days, 25th–75th percentile: 493–978] an event occurred in 45 patients (6.2%). After multivariate correction for clinical risk factors (age, gender, smoking, known CAD) and CTA, LVEF < 49% and LVESV > 90 ml were independent predictors of events with an incremental prognostic value over clinical risk factors and CTA (Table 1).
Conclusions: The present results suggest that LV function analysis provides independent and incremental prognostic information beyond anatomic assessment of CAD using CTA.
- © 2010 by American Heart Association, Inc.