Relationship between left atrial dimensions and global and regional fat depots.

Background and Objectives: The relationship between body fat depots and the left atrial (LA) dimensions has not been fully explored. Our objective is to determine if there is a relationship not only with total body fat depots, but specifically with regional fatty depots. Materials and Methods: It was an observational, retrospective study that included consecutive patients referred to our institution with an order to perform computed tomography angiography triggered by electrocardiogram for different clinical indications. Measurements of the LA were made in the systolic phase, using four and two cameras views. Results: A total of 87 patients were included. The mean age was 66.4 ± 12.5 years; 67% were men. The LA volume indexed by the body surface area was 48.0 ± 16.6 cm3/m2. We identified significant correlations between the LA dimensions and the age (p < 0.05). However, no significant correlations were found between the LA dimensions and the body fat depots, either total or regional. Conclusions: In this study, we did not identify significant relationships between LA dimensions and global or regional body fat depots.

Antecedentes y objetivos: La relación entre los depósitos de grasa corporal y las dimensiones de la aurícula izquierda (AI) no ha sido del todo explorada. Nuestro objetivo es determinar si existe relación no solo con los depósitos de grasa corporal totales, sino específicamente con los depósitos grasos regionales. Materiales y métodos: Estudio observacional, retrospectivo, que incluyó pacientes consecutivos remitidos a nuestra institución con orden de realización de angiotomografía computarizada toracoabdominal gatillada con electrocardiograma por distintas indicaciones clínicas. Las mediciones de la AI se realizaron en la fase sistólica, utilizando vistas de cuatro y dos cámaras. Resultados: Se incluyeron un total de 87 pacientes. La edad media fue de 66.4 ± 12.5 años; un 67% de los sujetos fueron hombres. El volumen de la AI indexado por la superficie corporal fue de 48.0 ± 16.6 cm3/m2. Identificamos correlaciones significativas entre las dimensiones de la AI y la edad (p < 0.05). Sin embargo, no se evidenciaron correlaciones significativas entre las dimensiones de la AI y los distintos depósitos de grasa corporal, ya sea totales o regionales. Conclusiones: En este estudio, no identificamos relaciones significativas entre las dimensiones de la AI y los depósitos de grasa corporal globales o regionales.

Relationship between left atrial dimensions and global and regional fat depots.

Background and Objectives: The relationship between body fat depots and the left atrial (LA) dimensions has not been fully explored. Our objective is to determine if there is a relationship not only with total body fat depots, but specifically with regional fatty depots. Materials and Methods: It was an observational, retrospective study that included consecutive patients referred to our institution with an order to perform computed tomography angiography triggered by electrocardiogram for different clinical indications. Measurements of the LA were made in the systolic phase, using four and two cameras views. Results: A total of 87 patients were included. The mean age was 66.4 ± 12.5 years; 67% were men. The LA volume indexed by the body surface area was 48.0 ± 16.6 cm3/m2. We identified significant correlations between the LA dimensions and the age (p < 0.05). However, no significant correlations were found between the LA dimensions and the body fat depots, either total or regional. Conclusions: In this study, we did not identify significant relationships between LA dimensions and global or regional body fat depots.

Antecedentes y objetivos: La relación entre los depósitos de grasa corporal y las dimensiones de la aurícula izquierda (AI) no ha sido del todo explorada. Nuestro objetivo es determinar si existe relación no solo con los depósitos de grasa corporal totales, sino específicamente con los depósitos grasos regionales. Materiales y métodos: Estudio observacional, retrospectivo, que incluyó pacientes consecutivos remitidos a nuestra institución con orden de realización de angiotomografía computarizada toracoabdominal gatillada con electrocardiograma por distintas indicaciones clínicas. Las mediciones de la AI se realizaron en la fase sistólica, utilizando vistas de cuatro y dos cámaras. Resultados: Se incluyeron un total de 87 pacientes. La edad media fue de 66.4 ± 12.5 años; un 67% de los sujetos fueron hombres. El volumen de la AI indexado por la superficie corporal fue de 48.0 ± 16.6 cm3/m2. Identificamos correlaciones significativas entre las dimensiones de la AI y la edad (p < 0.05). Sin embargo, no se evidenciaron correlaciones significativas entre las dimensiones de la AI y los distintos depósitos de grasa corporal, ya sea totales o regionales. Conclusiones: En este estudio, no identificamos relaciones significativas entre las dimensiones de la AI y los depósitos de grasa corporal globales o regionales.

Relación entre las dimensiones de la aurícula izquierda y los depósitos globales y regionales de grasa corporal / Relationship between left atrial dimensions and global and regional fat depots

Resumen Antecedentes y objetivos: La relación entre los depósitos de grasa corporal y las dimensiones de la aurícula izquierda (AI) no ha sido del todo explorada. Nuestro objetivo es determinar si existe relación no solo con los depósitos de grasa corporal totales, sino específicamente con los depósitos grasos regionales. Materiales y métodos: Estudio observacional, retrospectivo, que incluyó pacientes consecutivos remitidos a nuestra institución con orden de realización de angiotomografía computarizada toracoabdominal gatillada con electrocardiograma por distintas indicaciones clínicas. Las mediciones de la AI se realizaron en la fase sistólica, utilizando vistas de cuatro y dos cámaras. Resultados: Se incluyeron un total de 87 pacientes. La edad media fue de 66.4 ± 12.5 años; un 67% de los sujetos fueron hombres. El volumen de la AI indexado por la superficie corporal fue de 48.0 ± 16.6 cm3/m2. Identificamos correlaciones significativas entre las dimensiones de la AI y la edad (p < 0.05). Sin embargo, no se evidenciaron correlaciones significativas entre las dimensiones de la AI y los distintos depósitos de grasa corporal, ya sea totales o regionales. Conclusiones: En este estudio, no identificamos relaciones significativas entre las dimensiones de la AI y los depósitos de grasa corporal globales o regionales.

Abstract Background and Objectives: The relationship between body fat depots and the left atrial (LA) dimensions has not been fully explored. Our objective is to determine if there is a relationship not only with total body fat depots, but specifically with regional fatty depots. Materials and Methods: It was an observational, retrospective study that included consecutive patients referred to our institution with an order to perform computed tomography angiography triggered by electrocardiogram for different clinical indications. Measurements of the LA were made in the systolic phase, using four and two cameras views. Results: A total of 87 patients were included. The mean age was 66.4 ± 12.5 years; 67% were men. The LA volume indexed by the body surface area was 48.0 ± 16.6 cm3/m2. We identified significant correlations between the LA dimensions and the age (p < 0.05). However, no significant correlations were found between the LA dimensions and the body fat depots, either total or regional. Conclusions: In this study, we did not identify significant relationships between LA dimensions and global or regional body fat depots.

Extensión y distribución espacial de la carga ateroesclerótica mediante imágenes monocromáticas virtuales derivadas de tomografía computarizada de doble energía / Extension and spatial distribution of atherosclerotic burden using virtual monochromatic imaging derived from dual-energy computed tomography

Introducción y objetivos: Se analizaron las diferencias de carga ateroesclerótica observadas entre la coronariografía invasiva y las imágenes monocromáticas virtuales obtenidas con la tomografía computarizada de doble energía. Métodos: Se examinó con tomografía computarizada de doble energía y se clasificó a 80 pacientes consecutivos remitidos a una coronariografía invasiva según el grado de carga ateroesclerótica utilizando el índice pronóstico de enfermedad coronaria de Duke modificado, la puntuación de extensión de la enfermedad coronaria, la puntuación de afección de segmentos y la puntuación de estenosis de segmentos. Resultados: La media de la puntuación de afección de segmento (8,2 más o menos 3,9 frente a 6,0 más o menos 3,7; p < 0,0001), el índice de Duke modificado (4,33 más o menos 1,6 frente a 4,0 más o menos 1,7; p = 0,003), la puntuación de extensión de la enfermedad coronaria (4,84 más o menos 1,8 frente a 4,43 más o menos 2,1; p = 0,005) y la mediana de la puntuación de estenosis de segmento (13,5 [9,0-18,0] frente a 9,5 [5,0-15,0]; p < 0,0001) fueron significativamente superiores con la tomografía computarizada de doble energía que con la coronariografía invasiva. La tomografía computarizada de doble energía mostró un número de pacientes con alguna lesión del tronco coronario izquierdo significativamente mayor (46 [58%] frente a 18 [23%]; p < 0,0001) y con lesiones proximales graves (0,28 más o menos 0,03 frente a 0,26 más o menos 0,03; p < 0,0001) en comparación con lo observado en la coronariografía invasiva. Los grados de calcificación arterial coronaria por debajo y por encima de la mediana mostraron sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo del 100 y el 97%; el 86 y el 50%; el 93 y el 95% y el 100 y el 67% para la identificación de estenosis más que o igual a 50%. Conclusiones: La angiografía coronaria con tomografía computarizada de energía dual identificó una carga ateroesclerótica significativamente mayor que la observada con la coronariografía invasiva, en especial por lo que respecta a la afección de los segmentos proximales (AU)

Introduction and objectives: We explored the differences between atherosclerotic burden with invasive coronary angiography and virtual monochromatic imaging derived from dual-energy computed tomography coronary angiography. Methods: Eighty consecutive patients referred for invasive coronary angiography underwent dual-energy computed tomography coronary angiography and were categorized according to the atherosclerotic burden extent using the modified Duke prognostic coronary artery disease index, coronary artery disease extension score, segment involvement score, and the segment stenosis score. Results: The mean segment involvement score (8.2 more or less 3.9 vs 6.0 more or less 3.7; P < .0001), modified Duke index (4.33 more or less 1.6 vs 4.0 more or less 1.7; P = .003), coronary artery disease extension score (4.84 more or less 1.8 vs 4.43 more or less 2.1; P = .005), and the median segment stenosis score (13.5 [9.0-18.0] vs 9.5 [5.0-15.0]; P < .0001) were significantly higher on dual-energy computed tomography compared with invasive angiography. Dual-energy computed tomography showed a significantly higher number of patients with any left main coronary artery lesion (46 [58%] vs 18 [23%]; P < .0001) and with severe proximal lesions (0.28 more or less 0.03 vs 0.26 more or less 0.03; P < .0001) than invasive angiography. Levels of coronary artery calcification below and above the median showed a sensitivity, specificity, positive predictive value, and negative predictive value of 100% and 97%; 86% and 50%; 93% and 95%; 100% and 67% for the identification of is greater than or equal to 50% stenosis. Conclusions: Dual-energy computed tomography coronary angiography identified a significantly larger atherosclerotic burden compared with invasive coronary angiography, particularly involving the proximal segments (AU)

Reproducibility of Gadolinium Enhancement Patterns and Wall Thickness in Hypertrophic Cardiomyopathy / Reprodutibilidade de Padrões de Realce pelo Gadolínio e Espessura Parietal em Cardiomiopatia Hipertrófica

Abstract Background: Reproducibility data of the extent and patterns of late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) is limited. Objective: To explore the reproducibility of regional wall thickness (WT), LGE extent, and LGE patterns in patients with HCM assessed with cardiac magnetic resonance (CMR). Methods: The extent of LGE was assessed by the number of segments with LGE, and by the total LV mass with LGE (% LGE); and the pattern of LGE-CMR was defined for each segment. Results: A total of 42 patients (672 segments) with HCM constituted the study population. The mean WT measurements showed a mean difference between observers of -0.62 ± 1.0 mm (6.1%), with limits of agreement of 1.36 mm; -2.60 mm and intraclass correlation coefficient (ICC) of 0.95 (95% CI 0.93-0.96). Maximum WT measurements showed a mean difference between observers of -0.19 ± 0.8 mm (0.9%), with limits of agreement of 1.32 mm; -1.70 mm, and an ICC of 0.95 (95% CI 0.91-0.98). The % LGE showed a mean difference between observers of -1.17 ± 1.2 % (21%), with limits of agreement of 1.16%; -3.49%, and an ICC of 0.94 (95% CI 0.88-0.97). The mean difference between observers regarding the number of segments with LGE was -0.40 ± 0.45 segments (11%), with limits of agreement of 0.50 segments; -1.31 segments, and an ICC of 0.97 (95% CI 0.94-0.99). Conclusions: The number of segments with LGE might be more reproducible than the percent of the LV mass with LGE.

Resumo Fundamento: Os dados de reprodutibilidade da extensão e dos padrões de realce tardio pelo gadolínio (RTG) em cardiomiopatia hipertrófica (CMH) são limitados. Objetivo: Explorar a reprodutibilidade da espessura parietal (EP) da região, extensão do RTG e padrões de RTG em pacientes com CMH avaliados com ressonância magnética cardíaca (RMC). Métodos: A extensão do RTG foi avaliada pelo número de segmentos com RTG e pela massa total do VE com RTG (%RTG) e foi definido o padrão RMC com RTG para cada segmento. Resultados: A população do estudo foi composta por um total de 42 pacientes (672 segmentos) com CMH. As medições médias de EP mostraram uma diferença média entre observadores de -0,62 ± 1,0 mm (6,1%), com limites de concordância de 1,36 mm, -2,60 mm e um coeficiente de correlação intraclasse (CCI) de 0,95 (95% IC 0,93-0,96). Medições máximas de EP mostraram uma diferença média entre observadores de -0,19 ± 0,8 mm (0,9%), com limites de concordância de 1,32 mm, -1,70 mm e CCI de 0,95 (95% IC 0,91-0,98). O % RTG mostrou uma diferença média entre observadores de -1,17 ± 1,2% (21%), com limites de concordância de 1,16%, -3,49% e CCI de 0,94 (95% IC 0,88-0,97). A diferença média entre observadores com relação ao número de segmentos com RTG foi de -0,40 ± 0,45 segmentos (11%) com limites de concordância de 0,50 segmentos, -1,31 segmentos e CCI de 0,97 (95% IC 0,94-0,99). Conclusões: O número de segmentos com RTG pode ser mais reprodutível do que o percentual da massa do VE com RTG.

Reproducibility of Gadolinium Enhancement Patterns and Wall Thickness in Hypertrophic Cardiomyopathy.

BACKGROUND: Reproducibility data of the extent and patterns of late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) is limited. OBJECTIVE: To explore the reproducibility of regional wall thickness (WT), LGE extent, and LGE patterns in patients with HCM assessed with cardiac magnetic resonance (CMR). METHODS: The extent of LGE was assessed by the number of segments with LGE, and by the total LV mass with LGE (% LGE); and the pattern of LGE-CMR was defined for each segment. RESULTS: A total of 42 patients (672 segments) with HCM constituted the study population. The mean WT measurements showed a mean difference between observers of -0.62 ± 1.0 mm (6.1%), with limits of agreement of 1.36 mm; -2.60 mm and intraclass correlation coefficient (ICC) of 0.95 (95% CI 0.93-0.96). Maximum WT measurements showed a mean difference between observers of -0.19 ± 0.8 mm (0.9%), with limits of agreement of 1.32 mm; -1.70 mm, and an ICC of 0.95 (95% CI 0.91-0.98). The % LGE showed a mean difference between observers of -1.17 ± 1.2 % (21%), with limits of agreement of 1.16%; -3.49%, and an ICC of 0.94 (95% CI 0.88-0.97). The mean difference between observers regarding the number of segments with LGE was -0.40 ± 0.45 segments (11%), with limits of agreement of 0.50 segments; -1.31 segments, and an ICC of 0.97 (95% CI 0.94-0.99). CONCLUSIONS: The number of segments with LGE might be more reproducible than the percent of the LV mass with LGE.