Computed tomography and transthoracic echocardiography for assessment of left ventricle geometry in patients with aortic valve stenosis.

Abstract

Standard transthoracic echocardiography (TTE) often is not sufficient to properly visualize the geometry of the left ventricle. One of the clinical imaging modalities that can be used for this purpose is contrast-enhanced, electrocardiologically gated cardiac computed tomography (CT). To compare cardiac CT and TTE as tools for assessing geometry and function of the left ventricle in patients with severe aortic stenosis. We analyzed 58 consecutive patients (43.1% males, mean age 81.4 ±6.0 years) with severe aortic stenosis, who underwent both cardiac CT and TTE. Left ventricle major axis length is significantly longer in CT than in TTE (81.5 ±11.7 mm vs. 74.6 ±13.5 mm, p = 0.004). No difference was found in end-systolic left ventricle volume between the two imaging methods, while end-diastolic volume of the left ventricle was significantly larger when measured in CT than in both 2D biplane and 3D triplane TTE. The stroke volume was not different between the 2D biplane TTE and CT. No significant difference was found between CT and TTE in the calculation of ejection fraction and LV mass/indexed LV mass (p > 0.05). The use of three-dimensional postprocessing provides a very accurate image of heart structures in CT, which in some aspects may significantly differ from the values estimated by TTE.