chapter  18
14 Pages

Assessment of Global and Regional Left Ventricular Function by Computed Tomography

ByKai Uwe Juergens, Walter Heindel, Roman Fischbach

Ischemic heart disease is the leading cause of morbidity and

mortality in industrialized countries.1 For clinical diagnosis

and risk stratification in patients with suspected or docu-

mented heart disease, the accurate and reproducible deter-

mination of left ventricular (LV) myocardial function is of

utmost importance, as LV volumes and myocardial mass are

independent predictors of morbidity and mortality in

patients with coronary heart disease.2,3 Global LV function

is considered the strongest determinant of heart failure and

death due to myocardial infarction.4 Furthermore, the eval-

uation of LV function provides valuable information for

treatment planning, monitoring of the efficacy of treatment

as well as prognostic parameters in patients with ischemic

and nonischemic cardiomyopathy.3-5

Currently, global and regional LV function can be

assessed using different invasive modalities, i.e. mono-and

biplane cineventriculography, and noninvasive imaging

modalities, i.e. echocardiography,6-8 cine magnetic reso-

nance imaging (CMR),9-18 electron-beam computed tomo-

graphy (EBCT)19-23 as well as ECG-gated single photon

emission computed tomography (SPECT) and positron

emission tomography (PET).22-25 In clinical practice, the

assessment of LV volumes and function is most commonly

accomplished with echocardiography as a quick and widely

available bedside test as well as with CMR that is currently

considered the modality of reference for assessment of car-

diac function.8-10,14

In 1998, ECG-gated multi-detector row computed

tomography (MDCT) was introduced as a noninvasive car-

diac imaging technique primarily aiming at the detection of

coronary artery stenoses and cardiac morphology.