title: Impact of age and sex on left ventricular function determined by coronary computed tomographic angiography: results from the prospective multicentre CONFIRM study.
abstract: BACKGROUND
  Left ventricular (LV) volumetric and functional parameters measured with cardiac computed tomography (cardiac CT) augment risk prediction and discrimination for future mortality. Gender- and age-specific standard values for LV dimensions and systolic function obtained by 64-slice cardiac CT are lacking.
  
  
  RESULTS
  1155 patients from the Coronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry (54.5% males, mean age 53.1 ± 12.4 years, range: 18-92 years) without known coronary artery disease (CAD), structural heart disease, diabetes, or hypertension who underwent cardiac CT for various indications were categorized according to age and sex. A cardiac CT data acquisition protocol was used that allowed volumetric measuring of LV function. Image interpretation was performed at each site. Patients with significant CAD (>50% stenosis) on cardiac CT were excluded from the analysis. Overall, mean left ventricular ejection fraction (LVEF) was higher in women when compared with men (66.6 ± 7.7% vs. 64.6 ± 8.1%, P < 0.001). This gender-difference in overall LVEF was caused by a significantly higher LVEF in women ≥70 years when compared with men ≥70 years (69.95 ± 8.89% vs. 65.50 ± 9.42%, P = 0.004). Accordingly, a significant increase in LVEF was observed with age (P = 0.005 for males and P < 0.001 for females), which was more pronounced in females (5.21%) than in males (2.6%). LV end-diastolic volume decreased in females from 122.48 ± 27.87 (<40 years) to 95.56 ± 23.17 (>70 years; P < 0.001) and in males from 155.22 ± 35.07 (<40 years) to 130.26 ± 27.18 (>70 years; P < 0.001).
  
  
  CONCLUSIONS
  Our findings indicate that the LV undergoes a lifelong remodelling and highlight the need for age and gender adjusted reference values.
authors.affiliation: Department of Nuclear Medicine, University Hospital, Zurich, Switzerland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Gebhard
authors.affiliation: Department of Nuclear Medicine, University Hospital, Zurich, Switzerland.
authors.forename: Ronny R
authors.initials: RR
authors.lastname: Buechel
authors.affiliation: Department of Nuclear Medicine, University Hospital, Zurich, Switzerland.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Stähli
authors.affiliation: Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Gransar
authors.affiliation: Department of Medicine, University of Erlangen, Erlangen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.affiliation: Department of Imaging, Cedars Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.affiliation: Department of Medicine, Harbor UCLA Medical Center, Los Angeles, CA, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.affiliation: Tennessee Heart and Vascular Institute, Hendersonville, TN, USA.
authors.forename: Tracy Q
authors.initials: TQ
authors.lastname: Callister
authors.affiliation: Department of Medicine and Radiology, University of Ottawa, ON, Canada.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chow
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Allison
authors.initials: A
authors.lastname: Dunning
authors.affiliation: Department of Medicine, Wayne State University, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Mouaz H
authors.initials: MH
authors.lastname: Al-Mallah
authors.affiliation: Cardiovascular Imaging Unit, Giovanni XXIII Hospital, Monastier, Treviso, Italy.|Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
authors.affiliation: William Beaumont Hospital, Royal Oaks, MI, USA.
authors.forename: Kavitha
authors.initials: K
authors.lastname: Chinnaiyan
authors.affiliation: Department of Cardiology at the Lady Davis Carmel Medical Center, The Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Ronen
authors.initials: R
authors.lastname: Rubinshtein
authors.affiliation: Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
authors.forename: Hugo
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authors.lastname: Marques
authors.affiliation: Capitol Cardiology Associates, Albany, NY, USA.
authors.forename: Augustin
authors.initials: A
authors.lastname: DeLago
authors.affiliation: Department of Medicine, Walter Reed Medical Center, Washington, DC, USA.
authors.forename: Todd C
authors.initials: TC
authors.lastname: Villines
authors.affiliation: Division of Cardiology, Deutsches Herzzentrum Munchen, Munich, Germany.
authors.forename: Martin
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authors.lastname: Hadamitzky
authors.affiliation: Medizinische Klinik I der Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Hausleiter
authors.affiliation: Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Leslee J
authors.initials: LJ
authors.lastname: Shaw
authors.affiliation: Baptist Cardiac and Vascular Institute, Miami, FL, USA.
authors.forename: Ricardo C
authors.initials: RC
authors.lastname: Cury
authors.affiliation: Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Feuchtner
authors.affiliation: Seoul National University Hospital, Seoul, South Korea.
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Cardiovascular Imaging Unit, Giovanni XXIII Hospital, Monastier, Treviso, Italy.|Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Erica
authors.initials: E
authors.lastname: Maffei
authors.affiliation: William Beaumont Hospital, Royal Oaks, MI, USA.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Raff
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Centro Cardiologico Monzino, IRCCS, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors.forename: Hyuk-Jae
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Department of Radiology, NewYork-Presbyterian Hospital and the Weill Cornell Medical College, New York, NY, USA.
authors.forename: James K
authors.initials: JK
authors.lastname: Min
authors.affiliation: Department of Nuclear Medicine, University Hospital, Zurich, Switzerland.
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology
keywords: cardiac computed tomography; left ventricular ejection fraction