Ventricular Geometry From Non-contrast Non-ECG-gated CT Scans: An Imaging Marker of Cardiopulmonary Disease in Smokers

Farbod N Rahaghi, Gonzalo Vegas-Sanchez-Ferrero, Jasleen K Minhas, Carolyn E Come, Isaac De La Bruere, James M Wells, Germán González, Surya P Bhatt, Brett E Fenster, Alejandro A Diaz, Puja Kohli, James C Ross, David A Lynch, Mark T Dransfield, Russel P Bowler, Maria J Ledesma-Carbayo, Raúl San José Estépar, George R Washko, COPDGene Investigators, Edwin van Beek (Member of Group Organisation)

Research output: Contribution to journalArticlepeer-review

Abstract

RATIONALE AND OBJECTIVES: Imaging-based assessment of cardiovascular structure and function provides clinically relevant information in smokers. Non-cardiac-gated thoracic computed tomographic (CT) scanning is increasingly leveraged for clinical care and lung cancer screening. We sought to determine if more comprehensive measures of ventricular geometry could be obtained from CT using an atlas-based surface model of the heart.

MATERIALS AND METHODS: Subcohorts of 24 subjects with cardiac magnetic resonance imaging (MRI) and 262 subjects with echocardiography were identified from COPDGene, a longitudinal observational study of smokers. A surface model of the heart was manually initialized, and then automatically optimized to fit the epicardium for each CT. Estimates of right and left ventricular (RV and LV) volume and free-wall curvature were then calculated and compared to structural and functional metrics obtained from MRI and echocardiograms.

RESULTS: CT measures of RV dimension and curvature correlated with similar measures obtained using MRI. RV and LV volume obtained from CT inversely correlated with echocardiogram-based estimates of RV systolic pressure using tricuspid regurgitation jet velocity and LV ejection fraction respectively. Patients with evidence of RV or LV dysfunction on echocardiogram had larger RV and LV dimensions on CT. Logistic regression models based on demographics and ventricular measures from CT had an area under the curve of >0.7 for the prediction of elevated right ventricular systolic pressure and ventricular failure.

CONCLUSIONS: These data suggest that non-cardiac-gated, non-contrast-enhanced thoracic CT scanning may provide insight into cardiac structure and function in smokers.

Original languageEnglish
Pages (from-to)594-602
Number of pages9
JournalAcademic Radiology
Volume24
Issue number5
Early online date15 Feb 2017
DOIs
Publication statusPublished - May 2017

Keywords

  • Aged
  • Cardiac Volume
  • Echocardiography
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart Diseases
  • Heart Ventricles
  • Humans
  • Lung Diseases
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Smokers
  • Smoking
  • Stroke Volume
  • Tomography, X-Ray Computed
  • Ventricular Function
  • Journal Article
  • Observational Study

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