Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Using CT to Evaluate Cardiac Function

CT를 이용한 심장 기능 검사

  • Jongmin Lee (Department of Radiology, Kyungpook National University Hospital, Kyungpook National University School of Medicine)
  • 이종민 (경북대학교 의과대학 경북대학교병원 영상의학과)
  • Received : 2023.11.15
  • Accepted : 2024.03.05
  • Published : 2024.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

A comprehensive evaluation of cardiac function includes information in relation to cardiac output and systemic venous return. The heart is composed of four chambers: two atria and two ventricles, each with its own unique mechanical function. These four cardiac chambers, their valves, and the pulmonary circulation system are inter-related as they preload or afterload on each other. Cardiac dysfunction is a failure of global cardiac function, resulting in typical clinical manifestations. To investigate the underlying cause of cardiac dysfunction, a step-by-step evaluation of cardiac blood flow tracks is necessary. In this context, imaging markers showing details of the cardiac structures have an important role in assessing cardiac function. An image-based evaluation allows for investigation of function in terms of individual cardiac components. Evaluation of cardiac function using cardiac CT has recently been validated. This review aimed to discuss cardiac CT-based imaging markers for comprehensive and detailed cardiac function assessment.

심장 기능의 포괄적인 결과는 심장박출량과 전신 정맥 환류로 표현된다. 심장의 4개의 방실은 각자 고유한 기계적 기능을 가진다. 심장방실과 판막, 폐순환 시스템은 전부하 또는 후부하의 형태로 상호 연관되어 있다. 심장 기능 장애는 전반적인 심장 기능의 실패로 전형적인 임상 증상을 나타낸다. 심장 기능 장애의 근본 원인을 조사하려면 심장 내 혈류 유동 경로에 대한 단계별 평가가 필요하다. 이러한 맥락에서, 심장의 세부 구조를 볼 수 있는 영상검사의 표지자는 심장 기능 평가에 중요한 역할을 한다. 영상기반 평가를 통해 개별 심장 구성 요소의 기능을 단계별로 조사할 수 있다. 심장 기능 평가를 위한 영상검사 중 최근 심장 CT가 포함되고 검증되었다. 본 종설에서는 포괄적 및 단계별 심장 기능 평가를 위한 심장 CT 기반 영상 표지자에 대해 논의하겠다.

Keywords

References

  1. Lee J. Three-chamber function with cardiac CT. In Schoepf U, ed. CT of the heart. Contemporary medical imaging. 1st ed. Totowa, NJ: Humana 2019:423-440 
  2. Mohrman DE. Cardiovascular physiology. 6th ed. New York: McGraw-Hill 2006:256 
  3. Longo DL. Harrison's principles of internal medicine. New York: McGraw-Hill 2012 
  4. Takx RA, Moscariello A, Schoepf UJ, Barraza JM Jr, Nance JW Jr, Bastarrika G, et al. Quantification of left and right ventricular function and myocardial mass: comparison of low-radiation dose 2nd generation dual-source CT and cardiac MRI. Eur J Radiol 2012;81:e598-e604 
  5. Hergan K, Schuster A, Fruhwald J, Mair M, Burger R, Topker M. Comparison of left and right ventricular volume measurement using the Simpson's method and the area length method. Eur J Radiol 2008;65:270-278 
  6. Tanabe Y, Kido T, Kurata A, Sawada S, Suekuni H, Kido T, et al. Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial infarction. Eur Radiol 2017;27:1667-1675 
  7. Groen JM, van der Vleuten PA, Greuter MJ, Zijlstra F, Oudkerk M. Comparison of MRI, 64-slice MDCT and DSCT in assessing functional cardiac parameters of a moving heart phantom. Eur Radiol 2009;19:577-583 
  8. Fu H, Wang X, Diao K, Huang S, Liu H, Gao Y, et al. CT compared to MRI for functional evaluation of the right ventricle: a systematic review and meta-analysis. Eur Radiol 2019;29:6816-6828 
  9. Kara B, Nayman A, Guler I, Gul EE, Koplay M, Paksoy Y. Quantitative assessment of left ventricular function and myocardial mass: a comparison of coronary CT angiography with cardiac MRI and echocardiography. Pol J Radiol 2016;81:95-102 
  10. Rigolli M, Anandabaskaran S, Christiansen JP, Whalley GA. Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis. Open Heart 2016;3:e000388 
  11. Mao SS, Li D, Vembar M, Gao Y, Luo Y, Lam F, et al. Model-based automatic segmentation algorithm accurately assesses the whole cardiac volumetric parameters in patients with cardiac CT angiography: a validation study for evaluating the accuracy of the workstation software and establishing the reference values. Acad Radiol 2014;21:639-647 
  12. Nicol ED, Stirrup J, Roughton M, Padley SP, Rubens MB. 64-channel cardiac computed tomography: intraobserver and interobserver variability, part 2: global and regional ventricular function, mass, and first pass perfusion. J Comput Assist Tomogr 2009;33:169-174 
  13. Yang CC, Mok GS, Law WY, Hsu SM, Wu TH, Chen LK. Potential dose reduction of optimal ECG-controlled tube current modulation for 256-slice CT coronary angiography. Acad Radiol 2011;18:731-737 
  14. Zhang J, Kang S, Han D, Xie X, Deng Y. Application of intelligent optimal kV scanning technology (CARE kV) in dual-source computed tomography (DSCT) coronary angiography. Int J Clin Exp Med 2015;8:17644-17653 
  15. Kawel-Boehm N, Kronmal R, Eng J, Folsom A, Burke G, Carr JJ, et al. Left ventricular mass at MRI and long-term risk of cardiovascular events: the multi-ethnic study of atherosclerosis (MESA). Radiology 2019;293:107-114 
  16. Kang EJ, Lee KN, Choi WJ, Kim YD, Shin KM, Lim JK, et al. Left ventricular functional parameters and geometric patterns in Korean adults on coronary CT angiography with a 320-detector-row CT scanner. Korean J Radiol 2017;18:664-673 
  17. Vanhoenacker PK, Van Hoe LR. A simple method to estimate cardiac function during routine multi-row detector CT exams. Eur Radiol 2007;17:2845-2851 
  18. Zeb I, Li D, Nasir K, Gupta M, Kadakia J, Gao Y, et al. Computerized left ventricular regional ejection fraction analysis for detection of ischemic coronary artery disease with multidetector CT angiography. Int J Cardiovasc Imaging 2013;29:685-692 
  19. Rodrigues JCL, Rooms B, Hyde K, Rohan S, Nightingale AK, Paton J, et al. The corrected left ventricular ejection fraction: a potential new measure of ventricular function. Int J Cardiovasc Imaging 2021;37:1987-1997 
  20. Arenja N, Riffel JH, Fritz T, Andre F, Aus dem Siepen F, Mueller-Hennessen M, et al. Diagnostic and prognostic value of long-axis strain and myocardial contraction fraction using standard cardiovascular MR imaging in patients with nonischemic dilated cardiomyopathies. Radiology 2017;283:681-691 
  21. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29:277-314 
  22. Boogers MJ, van Werkhoven JM, Schuijf JD, Delgado V, El-Naggar HM, Boersma E, et al. Feasibility of diastolic function assessment with cardiac CT: feasibility study in comparison with tissue Doppler imaging. JACC Cardiovasc Imaging 2011;4:246-256 
  23. Qiao E, Amin K, Hippe DS, Krieger EV, Dubinsky TJ. The heart as a spring, the measurement of myocardial bounce to assess left ventricular function on cardiac MR. Int J Cardiovasc Imaging 2021;37:1699-1707 
  24. Guo X, Gong C, Song R, Wan K, Han Y, Chen Y. First-pass perfusion cardiovascular magnetic resonance parameters as surrogate markers for left ventricular diastolic dysfunction: a validation against cardiac catheterization. Eur Radiol 2022;32:8131-8139 
  25. Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim S. Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J 2016;37:1196-1207 
  26. Buss SJ, Schulz F, Mereles D, Hosch W, Galuschky C, Schummers G, et al. Quantitative analysis of left ventricular strain using cardiac computed tomography. Eur J Radiol 2014;83:e123-e130 
  27. Meenakshisundaram R, Kamaraj K, Murugan S, Thirumalaikolundusubramanian P. Aortic stiffness and distensibility among hypertensives. Ann N Y Acad Sci 2009;1173(Suppl 1):E68-E71 
  28. Hoit BD. Left atrial size and function: role in prognosis. J Am Coll Cardiol 2014;63:493-505 
  29. Boudoulas KD, Paraskevaidis IA, Boudoulas H, Triposkiadis FK. The left atrium: from the research laboratory to the clinic. Cardiology 2014;129:1-17 
  30. Aquaro GD, Pizzino F, Terrizzi A, Carerj S, Khandheria BK, Di Bella G. Diastolic dysfunction evaluated by cardiac magnetic resonance: the value of the combined assessment of atrial and ventricular function. Eur Radiol 2019;29:1555-1564 
  31. Kizer JR, Bella JN, Palmieri V, Liu JE, Best LG, Lee ET, et al. Left atrial diameter as an independent predictor of first clinical cardiovascular events in middle-aged and elderly adults: the Strong Heart Study (SHS). Am Heart J 2006;151:412-418 
  32. Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, et al. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol 2006;47:1018-1023 
  33. Caselli S, Canali E, Foschi ML, Santini D, Di Angelantonio E, Pandian NG, et al. Long-term prognostic significance of three-dimensional echocardiographic parameters of the left ventricle and left atrium. Eur J Echocardiogr 2010;11:250-256 
  34. Kuhl JT, Moller JE, Kristensen TS, Kelbaek H, Kofoed KF. Left atrial function and mortality in patients with NSTEMI an MDCT study. JACC Cardiovasc Imaging 2011;4:1080-1087 
  35. Lessick J, Mutlak D, Mutlak M, Sheik-Muhamad R, Naami R, Efraim R, et al. Left atrial function by cardiac computed tomography is a predictor of heart failure and cardiovascular death. Eur Radiol 2022;32:132-142 
  36. Al-Mohaissen MA, Chow BJW, Lee T, Chan KL. Left atrial-left ventricular angle, a new measure of left atrial and left ventricular remodeling. Int J Cardiovasc Imaging 2022;38:435-445 
  37. Pezel T, Ambale-Venkatesh B, Quinaglia T, Heckbert SR, Kato Y, de Vasconcellos HD, et al. Change in left atrioventricular coupling index to predict incident atrial fibrillation: the multi-ethnic study of atherosclerosis (MESA). Radiology 2022;303:317-326 
  38. Schweitzer A, Agmon Y, Aronson D, Abadi S, Mutlak D, Carasso S, et al. Assessment of left sided filling dynamics in diastolic dysfunction using cardiac computed tomography. Eur J Radiol 2015;84:1930-1937 
  39. Pickett CA, Cheezum MK, Kassop D, Villines TC, Hulten EA. Accuracy of cardiac CT, radionucleotide and invasive ventriculography, two- and three-dimensional echocardiography, and SPECT for left and right ventricular ejection fraction compared with cardiac MRI: a meta-analysis. Eur Heart J Cardiovasc Imaging 2015;16:848-852 
  40. Chang SA, Choe YH, Jang SY, Kim SM, Lee SC, Oh JK. Assessment of left and right ventricular parameters in healthy Korean volunteers using cardiac magnetic resonance imaging: change in ventricular volume and function based on age, gender and body surface area. Int J Cardiovasc Imaging 2012;28(Suppl 2):141-147 
  41. Sato T, Tsujino I, Oyama-Manabe N, Ohira H, Ito YM, Sugimori H, et al. Simple prediction of right ventricular ejection fraction using tricuspid annular plane systolic excursion in pulmonary hypertension. Int J Cardiovasc Imaging 2013;29:1799-1805 
  42. Chan AL, Juarez MM, Shelton DK, MacDonald T, Li CS, Lin TC, et al. Novel computed tomographic chest metrics to detect pulmonary hypertension. BMC Med Imaging 2011;11:7 
  43. Revel MP, Faivre JB, Remy-Jardin M, Delannoy-Deken V, Duhamel A, Remy J. Pulmonary hypertension: ECG-gated 64-section CT angiographic evaluation of new functional parameters as diagnostic criteria. Radiology 2009;250:558-566 
  44. Tan RT, Kuzo R, Goodman LR, Siegel R, Haasler GB, Presberg KW. Utility of CT scan evaluation for predicting pulmonary hypertension in patients with parenchymal lung disease. Chest 1998;113:1250-1256 
  45. Budoff MJ, Pagali SR, Hamirani YS, Chen A, Cheu G, Gao Y, et al. Sex-specific biatrial volumetric measurements obtained with use of multidetector computed tomography in subjects with and without coronary artery disease. Tex Heart Inst J 2014;41:286-292 
  46. Yeh BM, Kurzman P, Foster E, Qayyum A, Joe B, Coakley F. Clinical relevance of retrograde inferior vena cava or hepatic vein opacification during contrast-enhanced CT. AJR Am J Roentgenol 2004;183:1227-1232 
  47. Sivak JA, Raina A, Forfia PR. Assessment of the physiologic contribution of right atrial function to total right heart function in patients with and without pulmonary arterial hypertension. Pulm Circ 2016;6:322-328 
  48. Yamasaki Y, Nagao M, Kawanami S, Kamitani T, Sagiyama K, Yamanouchi T, et al. One-stop shop assessment for atrial septal defect closure using 256-slice coronary CT angiography. Eur Radiol 2017;27:697-704 
  49. Christiaens L, Varroud-Vial N, Ardilouze P, Ragot S, Mergy J, Bonnet B, et al. Real three-dimensional assessment of left atrial and left atrial appendage volumes by 64-slice spiral computed tomography in individuals with or without cardiovascular disease. Int J Cardiol 2010;140:189-196