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Gebhard, Catherine; Buechel, Ronny R.; Stahli, Barbara E.; Gransar, Heidi; Achenbach, Stephan; Berman, Daniel S.; Budoff, Matthew J.; Canister, Tracy Q.; Chow, Benjamin; Dunning, Allison; Al-Mallah, Mouaz H.; Cademartiri, Filippo; Chinnaiyan, Kavitha; Rubinshtein, Ronen; Marques, Hugo; DeLago, Augustin; Villines, Todd C.; Hadamitzky, Martin; Hausleiter, Jörg; Shaw, Leslee J.; Cury, Ricardo C.; Feuchtner, Gudrun; Kim, Yong-Jin; Maffei, Erica; Raff, Gilbert; Pontone, Gianluca; Andreini, Daniele; Chang, Hyuk-Jae; Leipsic, Jonathon; Minn, James K.; Kaufmann, Philipp A. (2017): Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study. In: European Heart Journal-Cardiovascular Imaging, Vol. 18, No. 9: pp. 990-1000
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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.