Assessment of global and regional left ventricular function and volumes with 64-slice multi-slice computed tomography: a comparison with 2D echocardiography

Introduction: In patients with coronary artery disease (CAD), LV function and volumes are important parameters for long-term prognosis. 64-slice MSCT allows non-invasive assessment of the coronary arteries, but the accuracy of 64-slice MSCT for assessment of LV volumes and function is unknown. Methods: A head-to-head comparison between 64-slice MSCT and 2D echocardiography was performed in 40 patients with known or suspected CAD. The LV end-diastolic (LVEDV) and LV end-systolic volume (LVESV) were determined and LV ejection fraction (LVEF) was derived. Regional wall motion was assessed visually using a 17-segment model. A 3-point scoring system was used to assign to each segment a wall motion score: 1=normokinesia, 2=hypokinesia, 3=aor dyskinesia. 2D echocardiography served as gold standard. Results: MSCT agreed well with 2D echocardiography for assessment of LVEDV (r=0.97; P <0.0001) and LVESV (r=0.98; P <0.0001). An excellent correlation between MSCT and 2D echocardiography was shown for evaluation of LVEF (r=0.91; P <0.0001). Agreement for assessment of regional wall motion was excellent (96%, κ=0.82). Conclusions: Accurate assessment of global and regional LV function and volumes is feasible with 64-slice MSCT. 080237 Henneman boek.indb 50 03-11-2008 10:56:43 51 Assessment of LV function with 64-slice MSCT Introduction Assessment of global and regional left ventricular (LV) function and volumes provides valuable information in patients with ischemic heart disease. Furthermore, LV ejection fraction (LVEF) is an important prognostic marker in coronary artery disease. Non-invasive imaging modalities for the evaluation of global and regional LV function and volumes include single photon emission computed tomography (SPECT), cardiac magnetic resonance imaging (CMR) and two-dimensional (2D) echocardiography. Over the past years, multi-slice computed tomography (MSCT) has proven to allow accurate non-invasive assessment of coronary artery disease. In addition, since MSCT data acquisition is gated to the electrocardiogram (ECG), global and regional LV function and LV volumes can be derived from the same dataset. The feasibility of MSCT for the evaluation of LV function has been investigated for 4-slice and 16-slice MSCT. However, the accuracy of 64-slice MSCT for the evaluation of global and regional LV function and volumes has not yet been investigated. The recently introduced 64-slice systems have even higher temporal and spatial resolution and allow the acquisition of high-resolution 3D images of the entire heart in less than 10 seconds. Assessment of global and regional LV function and LV volumes with MSCT, in addition to non-invasive evaluation of the coronary arteries in patients with known or suspected CAD, will optimize evaluation of patients with CAD. The purpose of the present study was to validate the assessment of global and regional LV function and LV volumes with 64-slice MSCT, using 2D echocardiography as the reference standard for these parameters.