CT Study Of Structure And Function Of Left Ventricular Of Coronary Artery Stenosis

【Objective】To evaluate the clinical value of the Automated Threshold-based Segmentation algorithmin the assessment of left ventricular structure and function, with the Simpson algorithm asthe reference standard.To discuss the correlation between the stenosis degree of the left anterior descendingcoronary and the structure and function of the left ventricular with256-slice CT.【Methods】Fifty-seven patients underwent coronary CT angiography. Left ventricular mass,LVend diastolic volume, LV end systolic volume, stroke volume and ejection fraction werepostprocessed separately by Simpson method and Automated Threshold-based Segmentationalgorithm. Statistical methods included paired T test, Pearson correlation analysis andBland-Altman analysis.Selected the patients whose test result were normal and simple left anterior descendingstenosis, Then, according to the stenosis degree, the patients were divided into four groups:normal, mild stenosis, moderate stenosis, severe stenosis. Single factor analysis wasperformed to analysis the correlation between the stenosis degree and the structure andfunction of the left ventricular.【Results】Automated Threshold-based Segmentation method had high correlation with Simpsonmethod (end systolic volume, r=0.96; end diastolic volume, r=0.97; stroke volume，r=0.93;ejection fraction, r=0.94; left ventricular mass，r=0.89; p <0.05). Bland-Altman analysesrevealed well consistency of the ESV and EF，but not good consistency of the EDV、SV、LVM。No difference was found among the four groups of ESV, EDV, SV, EF. However, the leftventricular mass index of the severe stenosis group was significant greater than the normalgroup and mild group. The end diastolic wall thickness of the moderate and severe group were partially thicker than the normal group. However, the end systolic wall thickness amongthese four groups was no significant difference.【Conclusion】Automated Threshold-based Segmentation algorithm should not be recommended inclinical practice.The different stenosis degree of the left anterior descending coronary have no effect onthe ESV, EDV, SV and EF.Severe stenosis degree of the left anterior descending coronary lead to the increase ofventricular mass，moderate and severe stenosis lead to partially increase of end-diastolic wallthickness.