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Accuracy of Diastolic Function by Cardiac Computed Tomography Relative to Echo-Doppler: Additive Clinical and Prognostic Value.

心脏计算机断层扫描相对于回声多普勒舒张功能的准确性: 附加的临床和预后价值。

  • 影响因子:1.48
  • DOI:10.1097/RCT.0000000000001136
  • 作者列表:"van der Veen HA","Lessick J","Abadi S","Mutlak D
  • 发表时间:2021-03-01
Abstract

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.

摘要

目的: 我们的目的是评估心脏计算机断层扫描 (CT) 和回声诊断晚期舒张功能障碍 (DD) 的一致性,并评估基于CT的参数的预后价值。 方法: 连续纳入100例1个月内同时行CT和多普勒超声检查的患者。根据左心房容积变化,通过CT评估舒张功能,并与超声心动图0 ~ 3级进行比较。随访患者的心脏死亡和心力衰竭住院的综合结果。 结果: 通过操作特征曲线分析,基于回波预测晚期DD的最佳基于CT的参数为左心房总排空分数。左心房总排空分数 <36% 的敏感性/特异性为76%/86%。echo和CT检测晚期 (2/3级) DD之间的一致性很大 (κ = 0.62,P <0.0001)。通过Cox多变量分析,左心房总排空分数是3年时结局的有力独立预测因子 (风险比,8.0 [2.2-28.4]; P <0.0001)。 结论: 基于ct的DD评估与基于回波多普勒的结果具有良好的一致性。左心房总排空分数似乎具有很强的预后价值。

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