Department of Clinical Sciences (Cardiology), College of Medicine, Princess Nourah Bint Abdulrahman University, PO Box 84428, Riyadh, 11671, Saudi Arabia.
University of Ottawa Heart Institute, Ottawa, ON, Canada.
Int J Cardiovasc Imaging. 2022 Feb;38(2):435-445. doi: 10.1007/s10554-021-02411-z. Epub 2021 Sep 22.
We assessed the left atrial-left ventricular (LA-LV) long axis angulation value as a new measure of LA remodeling, and studied its predictors, its effect on two-dimensional LA volume (2D LAVol) estimation, and optimization techniques for 2D LAVol values. Retrospective electrocardiogram-gated coronary computed tomographic angiograms of 164 consecutive patients were reviewed. The LA-LV angle was measured in reconstructed 3-chamber views, and its predictors were determined. The LAVol measured by the area-length method after image optimization along the LV long axis (AL) and the LA long axis (AC-AL), was compared with that measured by the three-dimensional (3D)-volumetric method. LAVol calculation was modified to minimize differences from the 3D values. LA-LV angles ranged from 0° to 63°. In the univariate analysis, decreasing angulation was significantly associated with increasing LV end-diastolic volume (LVEDV), mitral regurgitation grade, LV and LA anteroposterior dimensions, and decreasing LV ejection fraction (LVEF). On multivariate analysis, increasing LVEDV, MR, and LA anteroposterior dimension inversely correlated with angulation; LVEF was positively correlated. The AL and 3D methods significantly differed only for patients with angles ≤ 29.9°. Conversely, LAVol was overestimated for all angules by AC-AL. Modification of AL LAVol using a regression equation, or by substituting the shortest with the longest and average LA lengths in patients with angles ≤ 29.9° and 30-39.9°, respectively neutralized the difference. The LA-LV angle is a new measure of LA and LV remodeling predicted by LV size and function, MR, and LA-anteroposterior dimension. AL formula modifications based on angulation in LV-optimized views better correlate with the 3D method than LA-view modification.
我们评估了左心房-左心室（LA-LV）长轴角度值作为左心房重构的新指标，并研究了其预测因素、对二维左心房容积（2D LAVol）估计的影响，以及二维 LAVol 值的优化技术。回顾性分析了 164 例连续患者的心电图门控冠状动脉计算机断层血管造影图像。在重建的 3 腔视图中测量 LA-LV 角度，并确定其预测因素。通过沿 LV 长轴（AL）和左心房长轴（AC-AL）进行图像优化的面积-长度法测量 LAVol，并与三维（3D）容积法测量的 LAVol 进行比较。对 LAVol 计算进行了修改，以最大限度地减少与 3D 值的差异。LA-LV 角度范围为 0°至 63°。在单变量分析中，角度减小与 LV 舒张末期容积（LVEDV）、二尖瓣反流程度、LV 和 LA 前后径以及左室射血分数（LVEF）增加显著相关。多变量分析显示，LVEDV、MR 和 LA 前后径的增加与角度呈负相关；LVEF 与角度呈正相关。只有在角度≤29.9°的患者中，AL 和 3D 方法才会显著不同。相反，对于所有角度，AC-AL 都会高估 LAVol。对于角度≤29.9°和 30-39.9°的患者，分别通过使用回归方程或用最短和最长 LA 长度替代 AL 长度来修改 AL LAVol，可中和差异。LA-LV 角度是一种新的左心房和左心室重构指标，由 LV 大小和功能、MR 和 LA 前后径预测。基于 LV 优化视图中角度的 AL 公式修改比 LA 视图修改与 3D 方法相关性更好。
