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

Catherine Gebhard, Ronny R. Buechel, Barbara E Stähli, Heidi Gransar, Stephan Achenbach, Daniel S. Berman, Matthew J. Budoff, Tracy Q. Callister, Benjamin J W Chow, Allison Dunning, Mouaz H Al-Mallah, Filippo Cademartiri, Kavitha Chinnaiyan, Ronen Rubinshtein, Hugo Marques, Augustin DeLago, Todd C. Villines, Martin Hadamitzky, Joerg Hausleiter, Leslee J. ShawRicardo C. Cury, Gudrun Feuchtner, Yong Jin Kim, Erica Maffei, Gilbert Raff, Gianluca Pontone, Daniele Andreini, Hyuk Jae Chang, Jonathon Leipsic, James K. Min, Philipp A. Kaufmann

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Abstract

BACKGROUND: Left 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 RESULTS: 1155 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 = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (<40 years) to 95.56 ± 23.17 (>70 years; P < 0.001) and in males from 155.22 ± 35.07 (<40 years) to 130.26 ± 27.18 (>70 years; P < 0.001).

CONCLUSION: Our findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values.

Original languageEnglish
JournalEuropean Heart Journal Cardiovascular Imaging
DOIs
Publication statusE-pub ahead of print - Jul 26 2016

Keywords

  • Journal Article

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    Gebhard, C., Buechel, R. R., Stähli, B. E., Gransar, H., Achenbach, S., Berman, D. S., Budoff, M. J., Callister, T. Q., Chow, B. J. W., Dunning, A., Al-Mallah, M. H., Cademartiri, F., Chinnaiyan, K., Rubinshtein, R., Marques, H., DeLago, A., Villines, T. C., Hadamitzky, M., Hausleiter, J., ... Kaufmann, P. A. (2016). Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study. European Heart Journal Cardiovascular Imaging. https://doi.org/10.1093/ehjci/jew142