Circulation, Vol 72, 1355-1364, Copyright © 1985 by American Heart Association
AJ Feiring, JA Rumberger, SJ Reiter, DJ Skorton, SM Collins, MJ Lipton, CB Higgins, S Ell and ML Marcus
The development of left ventricular hypertrophy in patients with heart
disease often has far-reaching clinical implications with respect to
overall morbidity and mortality. Approaches used to assess left ventricular
mass include electrocardiography, echocardiography, contrast
ventriculography, single photon-emission tomography, and conventional
computed tomography. However, all of these modalities suffer from some
major draw back that precludes widespread application to all patients. In
this study we assessed the accuracy of determinations of left ventricular
mass in 22 dogs by rapid-acquisition (50 msec) computed axial tomography
(RACAT), an ultrafast computed tomographic (CT) instrument.
Electrocardiographically triggered, end- diastolic, short-axis cardiac
scans were obtained from apex to base during administration of intravenous
iodinated contrast. Myocardial edges were determined for each tomographic
scan by two methods: the regional half-contour method (the CT density half
way between that of the left ventricular myocardium and adjacent
ventricular cavities or lung) and "interactive plateau thresholding" of the
cardiac borders. Left ventricular mass by RACAT was calculated as the sum
of the mass of each individual scan from apex to base (modified Simpson's
rule). Postmortem left ventricular mass ranged from 58 to 160 g. The
correlation between true left ventricular mass and tomographically
determined mass was excellent (r = .99), with the slope and y intercept not
statistically different from 1 and 0, respectively. The standard error of
the estimate was 4.1 g. Interobserver and intraobserver variability for
determining left ventricular mass demonstrated excellent agreement (r = .99
and r = .99, respectively). We conclude that quantitative assessment of
left ventricular mass can be accurately and reproducibly performed in dogs
by rapid acquisition CT scanning. It is likely that this technique will be
readily transferable to the clinical settings and prove to be an important
method for quantifying left ventricular mass in patients.
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Determination of left ventricular mass in dogs with rapid-acquisition cardiac computed tomographic scanning
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