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Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease

For therapeutic decisions regarding uni- or biventricular surgical repair in congenital heart disease (CHD), left ventricular mass (LVM) is an important factor. The aim of this retrospective study was to determine the LVM of infants with CHD in thoracic computed tomography angiographies (CTAs) and t...

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Autores principales: Ellmann, Stephan, Nickel, Julie-Marie, Heiss, Rafael, El Amrani, Nouhayla, Wüst, Wolfgang, Rompel, Oliver, Rueffer, Andre, Cesnjevar, Robert, Dittrich, Sven, Uder, Michael, May, Matthias S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303678/
https://www.ncbi.nlm.nih.gov/pubmed/34359298
http://dx.doi.org/10.3390/diagnostics11071215
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author Ellmann, Stephan
Nickel, Julie-Marie
Heiss, Rafael
El Amrani, Nouhayla
Wüst, Wolfgang
Rompel, Oliver
Rueffer, Andre
Cesnjevar, Robert
Dittrich, Sven
Uder, Michael
May, Matthias S.
author_facet Ellmann, Stephan
Nickel, Julie-Marie
Heiss, Rafael
El Amrani, Nouhayla
Wüst, Wolfgang
Rompel, Oliver
Rueffer, Andre
Cesnjevar, Robert
Dittrich, Sven
Uder, Michael
May, Matthias S.
author_sort Ellmann, Stephan
collection PubMed
description For therapeutic decisions regarding uni- or biventricular surgical repair in congenital heart disease (CHD), left ventricular mass (LVM) is an important factor. The aim of this retrospective study was to determine the LVM of infants with CHD in thoracic computed tomography angiographies (CTAs) and to evaluate its usefulness as a prognostic parameter, with special attention paid to hypoplastic left heart (HLH) patients. Manual segmentation of the left ventricular endo- and epicardial volumes was performed in CTAs of 132 infants. LVMs were determined from these volumes and normalized to body surface area. LVMs of patients with different types of CHD were compared to each other using analyses of variances (ANOVA). An LVM cutoff for discrimination between uni- and biventricular repair was determined using receiver operating characteristics. Survival rates were calculated using Kaplan–Meier statistics. Patients with a clinical diagnosis of an HLH had significantly lower mean LVM (21.88 g/m(2)) compared to patients without applicable disease (50.22 g/m(2); p < 0.0001) and compared to other CHDs, including persistent truncus arteriosus, left ventricular outflow tract obstruction, transposition of the great arteries, pulmonary artery stenosis or atresia, and double-outlet right ventricle (all, p < 0.05). The LVM cutoff for uni- vs. biventricular surgery was 33.9 g/m(2) (sensitivity: 82.3%; specificity: 73.7%; PPV: 94.9%). In a subanalysis of HLH patients, a sensitivity of 50.0%, specificity of 100%, PPV of 100%, and NPV of 83.3% was determined. Patient survival was not significantly different between the surgical approaches or between patients with LVM above or below the cutoff. LVM can be measured in chest CTA of newborns with CHD and can be used as a prognostic factor.
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spelling pubmed-83036782021-07-25 Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease Ellmann, Stephan Nickel, Julie-Marie Heiss, Rafael El Amrani, Nouhayla Wüst, Wolfgang Rompel, Oliver Rueffer, Andre Cesnjevar, Robert Dittrich, Sven Uder, Michael May, Matthias S. Diagnostics (Basel) Article For therapeutic decisions regarding uni- or biventricular surgical repair in congenital heart disease (CHD), left ventricular mass (LVM) is an important factor. The aim of this retrospective study was to determine the LVM of infants with CHD in thoracic computed tomography angiographies (CTAs) and to evaluate its usefulness as a prognostic parameter, with special attention paid to hypoplastic left heart (HLH) patients. Manual segmentation of the left ventricular endo- and epicardial volumes was performed in CTAs of 132 infants. LVMs were determined from these volumes and normalized to body surface area. LVMs of patients with different types of CHD were compared to each other using analyses of variances (ANOVA). An LVM cutoff for discrimination between uni- and biventricular repair was determined using receiver operating characteristics. Survival rates were calculated using Kaplan–Meier statistics. Patients with a clinical diagnosis of an HLH had significantly lower mean LVM (21.88 g/m(2)) compared to patients without applicable disease (50.22 g/m(2); p < 0.0001) and compared to other CHDs, including persistent truncus arteriosus, left ventricular outflow tract obstruction, transposition of the great arteries, pulmonary artery stenosis or atresia, and double-outlet right ventricle (all, p < 0.05). The LVM cutoff for uni- vs. biventricular surgery was 33.9 g/m(2) (sensitivity: 82.3%; specificity: 73.7%; PPV: 94.9%). In a subanalysis of HLH patients, a sensitivity of 50.0%, specificity of 100%, PPV of 100%, and NPV of 83.3% was determined. Patient survival was not significantly different between the surgical approaches or between patients with LVM above or below the cutoff. LVM can be measured in chest CTA of newborns with CHD and can be used as a prognostic factor. MDPI 2021-07-06 /pmc/articles/PMC8303678/ /pubmed/34359298 http://dx.doi.org/10.3390/diagnostics11071215 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ellmann, Stephan
Nickel, Julie-Marie
Heiss, Rafael
El Amrani, Nouhayla
Wüst, Wolfgang
Rompel, Oliver
Rueffer, Andre
Cesnjevar, Robert
Dittrich, Sven
Uder, Michael
May, Matthias S.
Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title_full Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title_fullStr Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title_full_unstemmed Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title_short Prognostic Value of CTA-Derived Left Ventricular Mass in Neonates with Congenital Heart Disease
title_sort prognostic value of cta-derived left ventricular mass in neonates with congenital heart disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303678/
https://www.ncbi.nlm.nih.gov/pubmed/34359298
http://dx.doi.org/10.3390/diagnostics11071215
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