Left Ventricular Diastolic Dysfunction Assessment with Dual-Source CT

PLoS One. 2015 May 18;10(5):e0127289. doi: 10.1371/journal.pone.0127289. eCollection 2015.

Abstract

Purpose: To assess the impact of left ventricular (LV) diastolic dysfunction on left atrial (LA) phasic volume and function using dual-source CT (DSCT) and to find a viable alternative prognostic parameter of CT for LV diastolic dysfunction through quantitative evaluation of LA phasic volume and function in patients with LV diastolic dysfunction.

Materials and methods: Seventy-seven patients were examined using DSCT and Doppler echocardiography on the same day. Reservoir, conduit, and contractile function of LA were evaluated by measuring LA volume (LAV) during different cardiac phases and all parameters were normalized to body surface area (BSA). Patients were divided into four groups (normal, impaired relaxation, pseudonormal, and restrictive LV diastolic filling) according to echocardiographic findings. The LA phasic volume and function in different stages of LV diastolic function was compared using one-way ANOVA analysis. The correlations between indexed volume of LA (LAVi) and diastolic function in different stages of LV were evaluated using Spearman correlation analysis.

Results: LA ejection fraction (LAEF), LA contraction, reservoir, and conduit function in patients in impaired relaxation group were not different from those in the normal group, but they were lower in patients in the pseudonormal and restrictive LV diastolic dysfunction groups (P < 0.05). For LA conduit function, there were no significant differences between the patients in the pseudonormal group and restrictive filling group (P = 0.195). There was a strong correlation between the indexed maximal left atrial volume (LAVmax, r = 0.85, P < 0.001), minimal left atrial volume (LAVmin, r = 0.91, P < 0.001), left atrial volume at the onset of P wave (LAVp, r = 0.84, P < 0.001), and different stages of LV diastolic function. The LAVi increased as the severity of LV diastolic dysfunction increased.

Conclusions: LA remodeling takes place in patients with LV diastolic dysfunction. At the same time, LA phasic volume and function parameters evaluated by DSCT indicated the severity of the LV diastolic dysfunction. Quantitative analysis of LA phasic volume and function parameters using DSCT could be a viable alternative prognostic parameter of LV diastolic function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Echocardiography, Doppler
  • Female
  • Heart Atria / diagnostic imaging
  • Heart Atria / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Stroke Volume
  • Tomography, X-Ray Computed / methods*
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / physiopathology*

Grants and funding

The study was supported by the following fundings: grant numbers: 7142047, the URLs: http://www.bjnsf.org/nsf_tzgg/201401/t20140116_9626.html, Beijing National Science Foundation, ZYW; grant numbers: 81401375, the URLs: http://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list, National Natural Science Foundation Of China, ZYW; grant numbers: 81401385, the URLs: http://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list, National Natural Science Foundation Of China, HM; grant numbers: ZR2014HQ011, the URLs: http://www.sdnsf.gov.cn/portal/, Shandong Province Natural Science Foundation, HM; grant numbers: 2012090, Yantai City Science and Technology Development Plan, HM; grant numbers: 81200166, the URLs: http://isisn.nsfc.gov.cn/egrantindex/funcindex/prjsearch-list, National Natural Science Foundation Of China, YZ; The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.