Cardiothoracic Morphology Measures in Heart Failure Patients to Inform Device Designs
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Approximately 5.7 million people in the US are affected by congestive heart failure. This study aimed to quantitatively evaluate cardiothoracic morphology and variability within a cohort of heart failure patients for the purpose of optimally engineering cardiac devices for a variety of heart failure patients.
Co-registered cardiac-gated and non-gated chest computed tomography (CT) scans were analyzed from 20 heart failure patients (12 males; 8 females) who were primarily older adults (79.5 ± 8.8 years). Twelve cardiothoracic measurements were collected and compared to study sex and left ventricular (LV) ejection fraction (EF) type differences in cardiothoracic morphology.
Four measures were significantly greater in males compared to females: LV long-axis length, LV end diastolic diameter (LVEDD) at 50% length of the LV long-axis, the minimal distance between the sternum and heart, and the angle between the LV long-axis and coronal plane. Four measures were significantly greater in patients with reduced EF compared to preserved LV: LV long-axis length, LVEDD at 50% length of the LV long-axis, left ventricular volume normalized by body surface area, and the angle between the mitral valve plane and LV long-axis.
These cardiothoracic morphology measurements are important to consider in the design of cardiac devices for heart failure management (e.g. cardiac pacemakers, ventricular assist devices, and implantable defibrillators), since morphology differs by sex and ejection fraction.
KeywordsCardiac device Computational models Computed tomography Ejection fraction Electrocardiogram gated computed tomography Heart failure
The authors thank Caresse Hightower, Katelyn Greene, Elizabeth Lopez, Jennifer Dawkins, Casey Costa, and Xin Ye for their assistance with data collection. This work was supported by Medtronic [W-000617], and a National Science Foundation REU Site grant [Award No. 1559700].
No animal studies were carried out by the authors for this article.
Conflict of interest
Ashley A. Weaver report grants from Medtronic and the National Science Foundation during the conduct of the study. Ryan Lahm is an employee of Medtronic plc. Mona Saffarzadeh, James P. Gaewsky, Joshua Tan, Bharathi Upadhya, and Geoffrey T. Jao declare no conflict of interest.
Human Studies/Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). The study complied with Institutional Review Board policies approved by Wake Forest University.
Study concept and design: Ryan Lahm, Ashley A. Weaver. Acquisition of data: Mona Saffarzadeh, James P. Gaewsky, Joshua Tan, Ashley A. Weaver. Analysis and interpretation: Mona Saffarzadeh, James P. Gaewsky, Bharathi Upadhya, Geoffrey T. Jao, Ryan Lahm, Ashley A. Weaver. Study supervision: Ryan Lahm, Ashley A. Weaver.
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