title: Incremental prognostic value of left ventricular function analysis over non-invasive coronary angiography with multidetector computed tomography.
abstract: BACKGROUND
  The purpose of this study was to determine the prognostic value of computed tomography coronary angiography (CTA)-derived left ventricular (LV) function analysis and to assess its incremental prognostic value over the detection of significant stenosis using CTA.
  
  
  METHODS
  In 728 patients (400 males, mean age 55 ± 12 years) with known or suspected CAD, the presence of significant stenosis (≥ 50% stenosis) and LV function were assessed using CTA. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), and LV ejection fraction (LVEF) were calculated. LV function was assessed as a continuous variable and using cutoff values (LVEDV > 215 mL, LVESV > 90 mL, LVEF < 49%). The following events were combined in a composite end-point: all-cause mortality, non-fatal myocardial infarction, and unstable angina pectoris requiring hospitalization.
  
  
  RESULTS
  On CTA, a significant stenosis was observed in 221 patients (30%). During follow-up [median 765 days, 25-75th percentile: 493-978] an event occurred in 45 patients (6.2%). After multivariate correction for clinical risk factors and CTA, LVEF < 49% and LVESV > 90 mL were independent predictors of events with an incremental prognostic value over clinical risk factors and CTA.
  
  
  CONCLUSIONS
  The present results suggest that LV function analysis provides independent and incremental prognostic information beyond anatomic assessment of CAD using CTA.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. f.r.de_graaf@lumc.nl
authors.forename: Fleur R
authors.initials: FR
authors.lastname: de Graaf
authors.forename: Jacob M
authors.initials: JM
authors.lastname: van Werkhoven
authors.forename: Joëlla E
authors.initials: JE
authors.lastname: van Velzen
authors.forename: M Louisa
authors.initials: ML
authors.lastname: Antoni
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Boogers
authors.forename: Lucia J
authors.initials: LJ
authors.lastname: Kroft
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000368:Aged; D003251:Constriction, Pathologic; D017023:Coronary Angiography / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009038:Motion; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*