title: Ventricular Geometry From Non-contrast Non-ECG-gated CT Scans: An Imaging Marker of Cardiopulmonary Disease in Smokers.
abstract: OBJECTIVE
  Imaging-based assessment of cardiovascular structure and function provides clinically relevant information in smokers. Non-cardiac-gated thoracic computed tomographic (CT) scanning is increasingly leveraged for clinical care and lung cancer screening. We sought to determine if more comprehensive measures of ventricular geometry could be obtained from CT using an atlas-based surface model of the heart.
  
  
  METHODS
  Subcohorts of 24 subjects with cardiac magnetic resonance imaging (MRI) and 262 subjects with echocardiography were identified from COPDGene, a longitudinal observational study of smokers. A surface model of the heart was manually initialized, and then automatically optimized to fit the epicardium for each CT. Estimates of right and left ventricular (RV and LV) volume and free-wall curvature were then calculated and compared to structural and functional metrics obtained from MRI and echocardiograms.
  
  
  RESULTS
  CT measures of RV dimension and curvature correlated with similar measures obtained using MRI. RV and LV volume obtained from CT inversely correlated with echocardiogram-based estimates of RV systolic pressure using tricuspid regurgitation jet velocity and LV ejection fraction respectively. Patients with evidence of RV or LV dysfunction on echocardiogram had larger RV and LV dimensions on CT. Logistic regression models based on demographics and ventricular measures from CT had an area under the curve of >0.7 for the prediction of elevated right ventricular systolic pressure and ventricular failure.
  
  
  CONCLUSIONS
  These data suggest that non-cardiac-gated, non-contrast-enhanced thoracic CT scanning may provide insight into cardiac structure and function in smokers.
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115. Electronic address: frahaghi@partners.org.
authors.forename: Farbod N
authors.initials: FN
authors.lastname: Rahaghi
authors.affiliation: Department of Radiology, Harvard School of Medicine, Boston, MA; Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Vegas-Sanchez-Ferrero
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115.
authors.forename: Jasleen K
authors.initials: JK
authors.lastname: Minhas
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Come
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115.
authors.forename: Isaac
authors.initials: I
authors.lastname: De La Bruere
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Denver, Colorado.
authors.forename: James M
authors.initials: JM
authors.lastname: Wells
authors.affiliation: Department of Radiology, Harvard School of Medicine, Boston, MA.
authors.forename: Germán
authors.initials: G
authors.lastname: González
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Denver, Colorado.
authors.forename: Surya P
authors.initials: SP
authors.lastname: Bhatt
authors.affiliation: Division Cardiology, Department of Medicine, National Jewish Health, Denver, Colorado.
authors.forename: Brett E
authors.initials: BE
authors.lastname: Fenster
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Diaz
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Massachusetts General Hospital, Denver, Colorado.
authors.forename: Puja
authors.initials: P
authors.lastname: Kohli
authors.affiliation: Department of Radiology, Harvard School of Medicine, Boston, MA.
authors.forename: James C
authors.initials: JC
authors.lastname: Ross
authors.affiliation: Department of Radiology, National Jewish Health, Denver, Colorado.
authors.forename: David A
authors.initials: DA
authors.lastname: Lynch
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Denver, Colorado.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Dransfield
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, Colorado.
authors.forename: Russel P
authors.initials: RP
authors.lastname: Bowler
authors.affiliation: Biomedical Image Technologies, Universidad Politécnica de Madrid & CIBER-BBN, Madrid, Spain.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Ledesma-Carbayo
authors.affiliation: Department of Radiology, Harvard School of Medicine, Boston, MA.
authors.forename: Raúl
authors.initials: R
authors.lastname: San José Estépar
authors.affiliation: Pulmonary and Critical Care Division of Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, PBB-CA 3, Boston, MA 02115.
authors.forename: George R
authors.initials: GR
authors.lastname: Washko
mesh_terms: D000368:Aged; D002306:Cardiac Volume / Q000502:physiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D000074285:Smokers; D012907:Smoking / Q000009:adverse effects; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016276:Ventricular Function / Q000502:physiology*
keywords: COPD; COPDGene; Non-ECG-gated; cardiac; computed tomography; congestive heart failure; echocardiography; heart; left heart failure; non-contrast; pulmonary hypertension; right heart failure; smokers; ventricular geometry; ventricular volume