Accuracy of Diastolic Function by Cardiac Computed Tomography Relative to Echo-Doppler: Additive Clinical and Prognostic Value.

Abstract

We aimed to assess the agreement between cardiac computed tomography (CT) and echo for diagnosing advanced diastolic dysfunction (DD) and to assess the prognostic value of CT-based parameters. One hundred one consecutive patients who had both CT and echo-Doppler within 1 month were included. Diastolic function was assessed by CT using a previously validated method, based on left atrial volume changes, and compared with echocardiography grades 0 to 3. Patients were followed up for a combined outcome of cardiac death and hospitalization for heart failure. By operating characteristic curve analysis, the best CT-based parameter for predicting advanced DD based on echo was left atrial total emptying fraction. Left atrial total emptying fraction <36% had sensitivity/specificity of 76%/86%. Agreement between echo and CT for detecting advanced (grades 2/3) DD was substantial (κ = 0.62, P < 0.0001). By Cox multivariate analysis, left atrial total emptying fraction was a powerful independent predictor of outcome at 3 years (hazard ratio, 8.0 [2.2-28.4]; P < 0.0001). Computed tomography-based assessment of DD has a good agreement with echo-Doppler-based results. Left atrial total emptying fraction seems to have a strong prognostic value.