AI-enabled Cardiac Chambers Volumetry in Non-Contrast Cardiac CT scans Detect HFrEF vs. HFpEF

AUTHORS (FIRST NAME, LAST NAME):

Kyle Atlas, Chenyu Zhang, Anthony P. Reeves, Emily Jaalouk, Sanjay Manubolu, Song Shou Mao, Matthew Budoff, Morteza Naghavi.

1. The Lundquist Institute, Torrance, CA

2. HeartLung.AI, Houston, TX

3. Cornell University, Ithaca, NY

Abstract:

Introduction:

We examined whether artificial intelligence (AI)-enabled volumetry of cardiac chambers (AutoChamber) utilizing the CAC scan may distinguish heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF).

Methods:

We applied AI-enabled automated cardiac chambers to data from 75 patients who underwent both a cardiac CT scan and echocardiography at Harbor UCLA medical center. AutoChamber took on average 21 seconds per scan and reported estimated volume for left atrium (LA), left ventricle (LV), right atrium (RA), and right ventricle (RV). LV volume was indexed (LVVI) by dividing LV volume by body surface area (BSA) to allow a more accurate assessment of the size of the left ventricle relative to the size of the individual. The average BSA for males and female were 1.59 ± 0.3 and 1.29 ± 0.2, respectively. HFrEF and HFpEF were defined as EF<40% and EF>50% respectively.

Results:

Average EF was 57.5 ± 7.0 in males and 59.7 ± 8.1 in females, respectively. AutoChamber volume for HFpEF vs HFrEF were LA (84.8±35.3 vs 113.2±32.8 p=0.002), LV (109.9±36.7 vs 170.7±65.9 p=0.0007), RA (97.5±58.3 vs 117.2±51.1 p=0.18), RV (135.6±52.1 vs 176.2±70.8 p=0.008), LVW mass (116.1±39.1 vs 170.6+56.9 p=0.0005). Density plots in the figure show a clear distinction between HFpEF and HFrEF using AI measured LVVI and comparable results

Conclusion:

AI-enabled automated cardiac chambers volumetry can correlate well with echocardiography based LVVI and detects HFrEF vs HFpEF. Further studies are needed to evaluate the ability of AutoChamber for prospective detection of patients at risk of HFrEF vs HFpEF.

Abstract Graphic/Image Description:

AI-CAC LV volume index (LVVI) defined as LV volume divided by BSA was able to distinguish HFrEF vs. HFpEF (58.4±16.2 vs. 85.6±27, p=0.0005) comparably to echocardiography LVVI (50.7±14.9 vs. 85.7±27.3, p<0.0001). Density plots in the figure show a clear distinction between HFpEF and HFrEF using AI measured LVVI and comparable results.

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