TY - JOUR
T1 - Quantification of extracellular volume with cardiac computed tomography in patients with dilated cardiomyopathy
AU - Baggiano, Andrea
AU - Conte, Edoardo
AU - Spiritigliozzi, Luigi
AU - Mushtaq, Saima
AU - Annoni, Andrea
AU - Carerj, Maria Ludovica
AU - Cilia, Francesco
AU - Fazzari, Fabio
AU - Formenti, Alberto
AU - Frappampina, Antonio
AU - Fusini, Laura
AU - Gaudenzi Asinelli, Margherita
AU - Junod, Daniele
AU - Mancini, Maria Elisabetta
AU - Mantegazza, Valentina
AU - Maragna, Riccardo
AU - Marchetti, Francesca
AU - Penso, Marco
AU - Tassetti, Luigi
AU - Volpe, Alessandra
AU - Baessato, Francesca
AU - Guglielmo, Marco
AU - Rossi, Alexia
AU - Rovera, Chiara
AU - Andreini, Daniele
AU - Rabbat, Mark G.
AU - Guaricci, Andrea Igoren
AU - Pepi, Mauro
AU - Pontone, Gianluca
N1 - Publisher Copyright:
© 2023 Society of Cardiovascular Computed Tomography
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Cardiac computed tomography (CCT) was recently validated to measure extracellular volume (ECV) in the setting of cardiac amyloidosis, showing good agreement with cardiovascular magnetic resonance (CMR). However, no evidence is available with a whole-heart single source, single energy CT scanner in the clinical context of newly diagnosed left ventricular dysfunction. Therefore, the aim of this study was to test the diagnostic accuracy of ECVCCT in patients with a recent diagnosis of dilated cardiomyopathy, having ECVCMR as the reference technique. Methods: 39 consecutive patients with newly diagnosed dilated cardiomyopathy (LVEF <50%) scheduled for clinically indicated CMR were prospectively enrolled. Myocardial segment evaluability assessment with each technique, agreement between ECVCMR and ECVCCT, regression analysis, Bland-Altman analysis and interclass correlation coefficient (ICC) were performed. Results: Mean age of enrolled patients was 62 ± 11 years, and mean LVEF at CMR was 35.4 ± 10.7%. Overall radiation exposure for ECV estimation was 2.1 ± 1.1 mSv. Out of 624 myocardial segments available for analysis, 624 (100%) segments were assessable by CCT while 608 (97.4%) were evaluable at CMR. ECVCCT demonstrated slightly lower values compared to ECVCMR (all segments, 31.8 ± 6.5% vs 33.9 ± 8.0%, p < 0.001). At regression analysis, strong correlations were described (all segments, r = 0.819, 95% CI: 0.791 to 0.844). On Bland-Altman analysis, bias between ECVCMR and ECVCCT for global analysis was 2.1 (95% CI: −6.8 to 11.1). ICC analysis showed both high intra-observer and inter-observer agreement for ECVCCT calculation (0.986, 95%CI: 0.983 to 0.988 and 0.966, 95%CI: 0.960 to 0.971, respectively). Conclusions: ECV estimation with a whole-heart single source, single energy CT scanner is feasible and accurate. Integration of ECV measurement in a comprehensive CCT evaluation of patients with newly diagnosed dilated cardiomyopathy can be performed with a small increase in overall radiation exposure.
AB - Background: Cardiac computed tomography (CCT) was recently validated to measure extracellular volume (ECV) in the setting of cardiac amyloidosis, showing good agreement with cardiovascular magnetic resonance (CMR). However, no evidence is available with a whole-heart single source, single energy CT scanner in the clinical context of newly diagnosed left ventricular dysfunction. Therefore, the aim of this study was to test the diagnostic accuracy of ECVCCT in patients with a recent diagnosis of dilated cardiomyopathy, having ECVCMR as the reference technique. Methods: 39 consecutive patients with newly diagnosed dilated cardiomyopathy (LVEF <50%) scheduled for clinically indicated CMR were prospectively enrolled. Myocardial segment evaluability assessment with each technique, agreement between ECVCMR and ECVCCT, regression analysis, Bland-Altman analysis and interclass correlation coefficient (ICC) were performed. Results: Mean age of enrolled patients was 62 ± 11 years, and mean LVEF at CMR was 35.4 ± 10.7%. Overall radiation exposure for ECV estimation was 2.1 ± 1.1 mSv. Out of 624 myocardial segments available for analysis, 624 (100%) segments were assessable by CCT while 608 (97.4%) were evaluable at CMR. ECVCCT demonstrated slightly lower values compared to ECVCMR (all segments, 31.8 ± 6.5% vs 33.9 ± 8.0%, p < 0.001). At regression analysis, strong correlations were described (all segments, r = 0.819, 95% CI: 0.791 to 0.844). On Bland-Altman analysis, bias between ECVCMR and ECVCCT for global analysis was 2.1 (95% CI: −6.8 to 11.1). ICC analysis showed both high intra-observer and inter-observer agreement for ECVCCT calculation (0.986, 95%CI: 0.983 to 0.988 and 0.966, 95%CI: 0.960 to 0.971, respectively). Conclusions: ECV estimation with a whole-heart single source, single energy CT scanner is feasible and accurate. Integration of ECV measurement in a comprehensive CCT evaluation of patients with newly diagnosed dilated cardiomyopathy can be performed with a small increase in overall radiation exposure.
KW - Cardiac computed tomography
KW - Cardiovascular magnetic resonance
KW - Extracellular volume
KW - Left ventricle dysfunction
KW - Myocardial fibrosis
UR - http://www.scopus.com/inward/record.url?scp=85158031015&partnerID=8YFLogxK
U2 - 10.1016/j.jcct.2023.04.005
DO - 10.1016/j.jcct.2023.04.005
M3 - Article
C2 - 37147147
AN - SCOPUS:85158031015
SN - 1934-5925
VL - 17
SP - 261
EP - 268
JO - Journal of cardiovascular computed tomography
JF - Journal of cardiovascular computed tomography
IS - 4
ER -