Sex-Specific Biatrial Volumetric Measurements Obtained with Use of Multidetector Computed Tomography in Subjects with and without Coronary Artery Disease

Abstract

Atrial volumetric measurement has proven clinical implications. Advances in cardiac imaging, notably the precision enabled by multidetector computed tomography (MDCT),A trial volume enlargement is an important diagnostic and prognostic indicator for patients with coronary artery disease (CAD). In various diseases, an increase in left atrial (LA) size has been associated with poor outcomes. 1-5In patients with CAD, LA enlargement is a known risk factor for an unfavorable cardiovascular prognosis. 6 In addition, right atrial (RA) enlargement might indirectly contribute to this risk by affecting the systemic and coronary vasculature. Multidetector computed tomography (MDCT) enables 3-dimensional imaging of the heart and correlates well with results of echocardiography and magnetic resonance imaging (MRI).7 In this study, we used MDCT angiography to identify normal ranges of LA and RA volumes in men and women and to calculate the prevalence of atrial enlargement in individuals with CAD. Patients and MethodsThe study protocol and method of consent were approved by our institutional review board. We reviewed our clinical database of patients who had been examined for evaluation of coronary artery disease with use of computed tomographic angiography (CTA) in our department from November 2007 through December 2010. A total of 1,400 records were reviewed; any patient with a historical diagnosis of valvular disorders, atrial fibrillation, or pulmonary hypertension was excluded from consideration. The remaining 686 participants (Table I) subsequently underwent examination by means of electrocardiographic (ECG)-gated CTA. We estimated the presence and extent of CAD, and cardiac systolic function.We then divided the study population into a control group (203 healthy subjects) and an obstructive-CAD group (483 patients) as diagnosed by CTA. Exclusionary

Predicting Left Atrial Appendage Thrombus from Left Atrial Volume and Confirmation by Computed Tomography with Delayed Enhancement

“…In each phase, the LA and LV volumes were delineated according to the atrial and ventricular contours and calculated by using the Simpson method for numerical integration on an Advantage Workstation 4.6 (GE Healthcare). 10 The calculated volumes were then manually corrected for minor errors. The workstation software automatically calculated a time-volume curve.…”

Biatrial Volumetric Assessment by Non-ECG-Gated CT Pulmonary Angiography Correlated with Transthoracic Echocardiography in Patients with Normal Diastology

“…Whilst there are established reference ranges for normative RV volumes on TEE, there is very limited data on measurement of RA size and in particular, RA volumes by CT. A cut-off of >35 mm, in the transverse diameter, perpendicular to the interatrial septum, measured from septal wall to lateral wall has been proposed for RA enlargement, but this is based on historic data [ 28 ]. Few studies have used ECG-gated CT datasets for RA volumetry [ 6 , 29 , 30 ] and have shown that similar to LA, the CT-derived RA volumes also tend to be overestimated when compared with MRI [ 29 ] and echocardiography [ 30 ]. The differences in the temporal resolution may account for the inter-technique variability in the measurements.…”

“…However, there is limited published data regarding normal atrial size on CTPA. There are a number of ECG-gated CT angiography [ 5 , 6 , 7 ] based publications on atrial volumetry but this literature serves to illustrate the methodological differences between the different groups. Such lack of consensus translates to difficulty in establishing normative values.…”