Clinical and prognostic correlates of pulmonary congestion in coronary computed tomography angiography data sets
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Clinical and prognostic correlates of pulmonary congestion in coronary computed tomography angiography data sets. / Kühl, J Tobias; Kristensen, Thomas S; Thomsen, Anna F; Hindsø, Louise; Hansen, Kristoffer L; Nielsen, Olav W; Kelbæk, Henning; Kofoed, Klaus F.
I: Journal of Cardiovascular Computed Tomography, Bind 10, Nr. 6, 2016, s. 466-472.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Clinical and prognostic correlates of pulmonary congestion in coronary computed tomography angiography data sets
AU - Kühl, J Tobias
AU - Kristensen, Thomas S
AU - Thomsen, Anna F
AU - Hindsø, Louise
AU - Hansen, Kristoffer L
AU - Nielsen, Olav W
AU - Kelbæk, Henning
AU - Kofoed, Klaus F
N1 - Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
PY - 2016
Y1 - 2016
N2 - BACKGROUND: Signs of pulmonary congestion obtained from cardiac computed tomography angiographic (coronary CTA) images have not previously been related to clinical congestion or outcome and the clinical value is, therefore, unknown. Our objective was to test the hypothesis that signs of pulmonary congestion predict clinical heart failure and adverse outcome in patients with myocardial infarction.METHODS: Coronary CTA was performed before invasive treatment in 400 prospectively included patients with non ST segment elevation myocardial infarction in an observational study. Using a previously described chest computed tomography evaluation algorithm, patients were classified as having "no congestion", "mild to moderate congestion" or "severe congestion".RESULTS: Using multivariate analyses, presence of pulmonary congestion on coronary CTA images was associated with age, female gender, left ventricular ejection fraction (LVEF) and left atrial size. The diagnostic accuracy for predicting clinical heart failure, defined as Killip class >1, was: sensitivity: 83%, specificity: 69%, positive predictive value: 25%, and negative predictive value: 97%. The median follow-up time was 50 months and the study end-point of death or hospitalization due to heart failure was reached in 68 (16%) patients. In a Cox proportional hazards model with adjustments for known risk factors and Killip class, the presence of "mild to moderate congestion" and "severe congestion" was independently associated with adverse outcome (Hazard ratio: 2.6 (95% CI:1.3-5.0) and 3.2 (1.3-7.5)).CONCLUSION: Signs of pulmonary congestion on coronary CTA images are closely correlated to cardiac dysfunction, predict clinical heart failure, and provide prognostic value independent of LVEF and Killip class.
AB - BACKGROUND: Signs of pulmonary congestion obtained from cardiac computed tomography angiographic (coronary CTA) images have not previously been related to clinical congestion or outcome and the clinical value is, therefore, unknown. Our objective was to test the hypothesis that signs of pulmonary congestion predict clinical heart failure and adverse outcome in patients with myocardial infarction.METHODS: Coronary CTA was performed before invasive treatment in 400 prospectively included patients with non ST segment elevation myocardial infarction in an observational study. Using a previously described chest computed tomography evaluation algorithm, patients were classified as having "no congestion", "mild to moderate congestion" or "severe congestion".RESULTS: Using multivariate analyses, presence of pulmonary congestion on coronary CTA images was associated with age, female gender, left ventricular ejection fraction (LVEF) and left atrial size. The diagnostic accuracy for predicting clinical heart failure, defined as Killip class >1, was: sensitivity: 83%, specificity: 69%, positive predictive value: 25%, and negative predictive value: 97%. The median follow-up time was 50 months and the study end-point of death or hospitalization due to heart failure was reached in 68 (16%) patients. In a Cox proportional hazards model with adjustments for known risk factors and Killip class, the presence of "mild to moderate congestion" and "severe congestion" was independently associated with adverse outcome (Hazard ratio: 2.6 (95% CI:1.3-5.0) and 3.2 (1.3-7.5)).CONCLUSION: Signs of pulmonary congestion on coronary CTA images are closely correlated to cardiac dysfunction, predict clinical heart failure, and provide prognostic value independent of LVEF and Killip class.
KW - Aged
KW - Chi-Square Distribution
KW - Computed Tomography Angiography
KW - Coronary Angiography
KW - Disease Progression
KW - Female
KW - Heart Failure
KW - Hospitalization
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Multidetector Computed Tomography
KW - Multivariate Analysis
KW - Non-ST Elevated Myocardial Infarction
KW - Predictive Value of Tests
KW - Proportional Hazards Models
KW - Prospective Studies
KW - Pulmonary Edema
KW - Reproducibility of Results
KW - Risk Factors
KW - Severity of Illness Index
KW - Stroke Volume
KW - Time Factors
KW - Ventricular Function, Left
KW - Journal Article
KW - Observational Study
U2 - 10.1016/j.jcct.2016.09.002
DO - 10.1016/j.jcct.2016.09.002
M3 - Journal article
C2 - 27717753
VL - 10
SP - 466
EP - 472
JO - Journal of Cardiovascular Computed Tomography
JF - Journal of Cardiovascular Computed Tomography
SN - 1934-5925
IS - 6
ER -
ID: 176953086