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OtherQuality & Practice Management (JNMT)

Evaluation of left atrium indices among high heart rate and heart rate variability patients with advancement in computed tomography technology: The CONVERGE registry.

Lavanya Cherukuri, Divya Birudaraju, April Kinninger, Bhanu T Chaganti, Sivakrishna Pidikiti, Ryan G Pozon, Anne Concepcion G Pozon, Suvasini Lakshmanan, Suraj Dahal, Sajad Hamal, Ferdinand Flores, Christopher Dialing, Daniele Andreini, Gianluca Pontone, Edoardo Conte, Rine Nakanishi, Rachael O'Rourke, Christian Hamilton-Craig, Khurram Nasir, Sion K Roy, Song Shou Mao and Matthew J Budoff
Journal of Nuclear Medicine Technology November 2020, jnmt.120.253781; DOI: https://doi.org/10.2967/jnmt.120.253781
Lavanya Cherukuri
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Divya Birudaraju
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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April Kinninger
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Bhanu T Chaganti
2 Texas Tech University Health Sciences Center, United States;
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Sivakrishna Pidikiti
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Ryan G Pozon
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Anne Concepcion G Pozon
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Suvasini Lakshmanan
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Suraj Dahal
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Sajad Hamal
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Ferdinand Flores
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Christopher Dialing
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Daniele Andreini
3 Centro Cardiologico Monzino, IRCCS and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Italy;
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Gianluca Pontone
4 Centro Cardiologico Monzino, IRCCS, Italy;
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Edoardo Conte
4 Centro Cardiologico Monzino, IRCCS, Italy;
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Rine Nakanishi
5 Department of Cardiovascular Medicine, Toho University Graduate School of Medicine, Tokyo, Japan, Japan;
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Rachael O'Rourke
6 Department of Medical Imaging, The Prince Charles Hospital, Australia;
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Christian Hamilton-Craig
6 Department of Medical Imaging, The Prince Charles Hospital, Australia;
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Khurram Nasir
7 Baptist Heart Medical Group, Miami FL, United States
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Sion K Roy
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Song Shou Mao
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Matthew J Budoff
1 The Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical Center, United States;
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Abstract

Introduction: We intended to assess the ability of current generation 256-slice coronary computed tomographic angiography (CCTA) to measure LA volume (LAV) comparing patients with high heart rate (HiHR) of > 70bpm and heart rate variability such as atrial fibrillation (AFib). Methods: Using the prospective CONVERGE Registry of patients undergoing 256 detector CCTA (Revolution, GE Healthcare, Milwaukee WI), we enrolled 121 high HR patients (74 men; mean age 62.7+12.5yrs) and 102 patients with AFib (72 men; mean age 60.5+11.0yrs) after obtaining the informed consent. Quantitative data analyses of LAV was performed using automated methods on a workstation and software (AW4.6; GE Medical Systems, Waukesha, WI, USA) and end-systolic phases were chosen for measurements from CCTA. A student’s t test, Wilcoxon rank-sum or chi-square tests assessed baseline parameters. Univariate and multivariate linear regression analysis was used to assess LAV and LAV index (LAVI) while adjusting potentially confounding variables. Results: Mean LAV in AFib subjects was significantly higher (148.6 ± 57.2mL), compared to HiHR subjects (102.1 ± 36.5mL), p<0.0001. Similarly, mean LAVI in AFib subjects was significantly higher (72.4 ± 28.1 ml/m2) than HiHR subjects’ LAVI, (51.5 ± 19.0 ml/m2) p<0.0001. After adjusting age, BMI, gender, diabetes, hypertension, hyperlipidemia, and smoking and those with AFib had on average higher LAV measures by 41.2±6.7 mL and LAVI by 23.1±3.4 ml/m2, p<0.0001. Conclusion: Misalignments and motion artifacts of CCTA images affects the CT diagnostic performance especially in patients with elevated heart rates or profound arrhythmia. However, the new generation Revolution CCTA provides the detailed LA complex morphology and function in HiHR and AFib patients in addition to coronary anatomy without additional radiation, scanning or contrast requirements.

  • Cardiology (basic/technical)
  • PET/CT
  • Radiation Physics
  • Other
  • Left atrial volume (LAV),
  • arrhythmia
  • heart rate variability
  • high heart rate
  • motion artifacts

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Journal of Nuclear Medicine Technology: 48 (4)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 4
December 1, 2020
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Evaluation of left atrium indices among high heart rate and heart rate variability patients with advancement in computed tomography technology: The CONVERGE registry.
Lavanya Cherukuri, Divya Birudaraju, April Kinninger, Bhanu T Chaganti, Sivakrishna Pidikiti, Ryan G Pozon, Anne Concepcion G Pozon, Suvasini Lakshmanan, Suraj Dahal, Sajad Hamal, Ferdinand Flores, Christopher Dialing, Daniele Andreini, Gianluca Pontone, Edoardo Conte, Rine Nakanishi, Rachael O'Rourke, Christian Hamilton-Craig, Khurram Nasir, Sion K Roy, Song Shou Mao, Matthew J Budoff
Journal of Nuclear Medicine Technology Nov 2020, jnmt.120.253781; DOI: 10.2967/jnmt.120.253781

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Evaluation of left atrium indices among high heart rate and heart rate variability patients with advancement in computed tomography technology: The CONVERGE registry.
Lavanya Cherukuri, Divya Birudaraju, April Kinninger, Bhanu T Chaganti, Sivakrishna Pidikiti, Ryan G Pozon, Anne Concepcion G Pozon, Suvasini Lakshmanan, Suraj Dahal, Sajad Hamal, Ferdinand Flores, Christopher Dialing, Daniele Andreini, Gianluca Pontone, Edoardo Conte, Rine Nakanishi, Rachael O'Rourke, Christian Hamilton-Craig, Khurram Nasir, Sion K Roy, Song Shou Mao, Matthew J Budoff
Journal of Nuclear Medicine Technology Nov 2020, jnmt.120.253781; DOI: 10.2967/jnmt.120.253781
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Keywords

  • Cardiology (basic/technical)
  • PET/CT
  • Radiation Physics
  • Other
  • Left atrial volume (LAV),
  • arrhythmia
  • heart rate variability
  • high heart rate
  • motion artifacts
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