Abstract 18797: Left Ventricle Area on Non-contrast CT Predicts Cardiovascular Events Above and Beyond Coronary Artery Calcium Scores: The Multi-Ethnic Study of Atherosclerosis
Background: While the prognositc value of coronary artery calcium (CAC) on non contrast CT is well established, little is known whether left ventricle area (LVA) that can be obtained from a single slice in the same scan can provide added information in predicting cardiovascular events.
Methods: A total of 6809 participants in the MESA study underwent NCE-CT at the baseline examination and were followed up for a median of 5 years. High-resolution CT studies (0.56×0.56 mm) were obtained to determine LVA using a single mid-slice area at the level containing the coronary sinus slice or the first level below the left atrium during mid-diastole. The LVA calculated was adjusted to body-surface area (BSA) in all participants.
Results: The mean age of the study population was 62 ± 10 years (53% females). The mean BSA-LVA was 2158±1206 ml. A total of 385 (5.7%) events were recorded during following. Table below shows that in adjusted models, the end points of incident CHD, CHF and stroke were positively associated with increased body surface adjusted LVA. The likelihood ratio chi2 statistics demonstrated that the addition of BSA-adjusted LVA contributed significantly in predicting CHD events and CHF to both traditional risk factors alone (all CHD: chi square= 104.57, p<0.0001, hard CHD: chi2= 52.84, p<0.0001, CHF: 56.91, p<0.0001 ) as well as risk factors+CAC scores (all CHD: chi2= 6.23, p=0.0125, hard CHD: chi2= 8.15, p=0.0004, CHF: 49.12, p<0.0001). On the other hand, addition of BSA-adjusted LVA did not contribute in a statistical significant fashion in prediction of stroke to models employing traditional risk factors (chi2= 3.56, p=0.46,) as well as risk factors+CAC scores (chi2= 2.45, p=0.12).
Conclusion: Determination of LVA is significantly associated with cardiovascular events and the strongest relationship was observed with incident CHF. The prognostic information is independent and beyond traditional risk factors and CAC scores without any additional scanning and
- © 2010 by American Heart Association, Inc.