An Automatic Four Chamber Volumetric Analysis (4CVA) Discloses Myocardial Stress in Individuals without Known Cardiac Disease - The 64th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 25-26 April 2017

Zach Rozenbaum ^1,5 Yaron Arbel ^2,5 Yoav Granot ^1,5 Tomer Ziv-Baran ⁴ Ehud Chorin ^2,5 Shlomo Berliner ^1,5 Haim Shmilovich ^2,5 Dotan Cohen ^3,5 Ofer Havakuk ^2,5 Galit Aviram ^3,5

¹Internal Medicine, Sourasky Medical Center
²Cardiology, Sourasky Medical Center
³Radiology, Sourasky Medical Center
⁴Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University
⁵Sackler Faculty of Medicine, Tel Aviv University

Introduction:
Previous echocardiographic studies have revealed an association between enlarged cardiac chamber volumes and elevated troponin concentrations. An automatic four chamber volumetric analysis (4CVA) tool was adopted to investigate this association in patients who undergo cardiac computed tomography angiography (CCTA).

Methods:
Serum troponin was obtained from 157 patients who underwent gated CCTA. Volumes of the cardiac chambers were automatically analyzed and compared between those within the upper quartile and the three lower quartiles of troponin concentrations.

Results:
There were no significant differences in baseline characteristics between the groups. Both ventricles and the left atrium were significantly enlarged in patients with troponin>0.007 ng/ml (n=39). When excluding patients with cardiac diseases, the left (OR 1.052, 1.014-1.090; p=0.006) and right (OR 1.056, 1.015-1.099; p=0.008) ventricles, as well as the left atrium (OR 1.056, 1-1.092; p=0.05) were larger in patients with higher troponin concentrations in a uni- and multi-variable analysis.

Conclusion:
This is the first study to report an association between larger cardiac chambers and higher levels of troponin concentrations by using the technology of automatic volumetric analysis in individuals who were referred to CCTA.