Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study

Abstract

BackgroundLeft ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender-and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking. Methods and results1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 + 12.4 years, range: 18 -92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (.50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 + 7.7% vs. 64.6 + 8.1%, P , 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 + 8.89% vs. 65.50 + 9.42%, P ¼ 0.004). Accordingly, a significant increase in LVEF was observed with age (P ¼ 0.005 for males and P , 0.001 for females), which was more pronounced in females (5.21%) than in males

Age- and sex-dependent changes in sympathetic activity of the left ventricular apex assessed by 18F-DOPA PET imaging

“…Indeed, a stronger effect of age on LV size and function has been observed in women as compared to men as recent observational studies have reported a higher percentage of small hearts alongside a higher LV ejection fraction in aged females as compared to younger women and age-matched men. [ 28 ]…”

Increased long-term mortality in women with high left ventricular ejection fraction: data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter) long-term registry

“…[1][2][3] Recent experimental and clinical studies indicate that there are significant sex-and age-specific differences in baseline left ventricular ejection fraction (LVEF). [4][5][6] Indeed, LV function is significantly higher in women than in men, and these differences further augment with age. [4][5][6] The latter is consistent with the observation that the risk of cardiovascular events starts at higher LVEF indices in women than in men.…”

“…[4][5][6] Indeed, LV function is significantly higher in women than in men, and these differences further augment with age. [4][5][6] The latter is consistent with the observation that the risk of cardiovascular events starts at higher LVEF indices in women than in men. 7 Similarly, despite their higher mortality rates, LV function is relatively better preserved in women with coronary artery disease (CAD), even when adjusting for age and comorbidities.…”

Assessment of Accuracy in Calculating Hemodynamic Parameters and Left Ventricular Mass According to ECG-Synchronized Myocardial Perfusion Scintigraphic Data: Comparison with Cardiac Multislice Computed Tomography

“…Кроме того, МРТ противопоказана для пациентов с имплантированными кардиостимуляторами, а также требует длительного сбора данных и проведения серии эпизодов задержки дыхания, что выполнимо не для всех пациентов кардиологического профиля. Параметры гемодинамики и массу миокарда ЛЖ также можно с высокой точностью вычислить при помощи МСКТ сердца [11]. Основными преимуществами данного подхода являются быстрота сканирования (не более 7-10 с на большинстве современных сканеров), а также возможность исследования пациентов с искусственными водителями ритма и кардиоресинхронизирующими устройствами [12].…”