Cardona Andrea, Trovato Vincenzo, Nagaraja Haikady N, Raman Subha V, Harfi Thura T
The Ohio State University Wexner Medical Center, 473 W 12th Avenue, Suite 200, Columbus, OH, 43210, United States of America.
The Ohio State University School of Medicine, 125 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, United States of America.
Int J Cardiol Heart Vasc. 2019 Mar 30;23:100351. doi: 10.1016/j.ijcha.2019.100351. eCollection 2019 Jun.
Left atrial volume (LAV) is an independent prognosticator of cardiovascular events. We investigated whether LAV could be accurately and reliably measured using coronary calcium score (CAC) scan.
We retrospectively selected consecutive patients that underwent coronary CT angiography (CCTA) and CAC scans. A standardized approach to calculate LAV on images was implemented. The measurements of the LAV on CAC scans and CCTA were performed one to three weeks apart in a random fashion by two readers blinded to the results of each other. The LAV measurements from CAC scan were compared to those from CCTA using correlation analysis. Inter-observer and intra-observer agreement of LAV measurement using CAC scan was evaluated.
Final analysis included one hundred subjects, mean age 52 ± 12 years, 48% male. There was a trend of a marginally larger, albeit not clinically significant, mean LAV calculated using CAC scan compared to that using CCTA: 74.3 vs. 71.0 mL: < 0.001; for reader 1, and 71.7 vs. 71.2 mL = 0.06 for reader 2, respectively. LAV using CAC scan and CCTA were highly correlated ( = 0.954, < 0.001 for reader1 and = 0.945, < 0.001 for reader 2). There was high reproducibility within each reader with ICC of 0.951 and 0.989 for readers 1 and 2, respectively ( < 0.001). Finally, there was high inter-observer agreement as indicated by of 0.97 and ICC of 0.96 ( < 0.001 for both).
Quantification of LAV from CAC scan using the proposed standardized approach is feasible, highly reliable and reproducible as compared to CCTA.
左心房容积（LAV）是心血管事件的独立预后指标。我们研究了是否可以使用冠状动脉钙化积分（CAC）扫描准确且可靠地测量LAV。
我们回顾性选择了连续接受冠状动脉CT血管造影（CCTA）和CAC扫描的患者。实施了一种在图像上计算LAV的标准化方法。由两名对彼此结果不知情的读者以随机方式在相隔一至三周的时间对CAC扫描和CCTA上的LAV进行测量。使用相关性分析将CAC扫描的LAV测量结果与CCTA的结果进行比较。评估了使用CAC扫描进行LAV测量的观察者间和观察者内一致性。
最终分析纳入了100名受试者，平均年龄52±12岁，48%为男性。与使用CCTA相比，使用CAC扫描计算的平均LAV有略微更大的趋势，尽管无临床意义：读者1分别为74.3 vs. 71.0 mL，P<0.001；读者2分别为71.7 vs. 71.2 mL，P = 0.06。使用CAC扫描和CCTA的LAV高度相关（读者1：r = 0.954，P<0.001；读者2：r = 0.945，P<0.001）。每个读者内部的重复性都很高，读者1和读者2的组内相关系数（ICC）分别为0.951和0.989（P<0.001）。最后，观察者间一致性很高，组内相关系数（ICC）为0.96，一致性相关系数（ ）为0.97（两者P<0.001）。
与CCTA相比，使用所提出的标准化方法从CAC扫描中定量LAV是可行的、高度可靠且可重复的。
