ArticleAmerican journal of preventive cardiology2027
Heart failure and atrial fibrillation prediction from non-gated chest CT scans using AI-based cardiac chamber volumetry: an AI-CVD study within the multi-ethnic study of atherosclerosis (MESA).
Article in American journal of preventive cardiology, 2027. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: We previously demonstrated that AI-derived cardiac chamber volumetry in ECG-gated CT scans predicts atrial fibrillation (AF) and heart failure (HF). Since most chest CTs are non-gated, and the American Heart Association recently highlighted their value for opportunistic cardiovascular risk assessment using AI-based coronary artery calcium scoring, we extended this concept to evaluate whether AI-derived chamber volumetry from non-gated CTs can reliably predict HF and AF.s. Methods: We compared AI-derived chamber volumetry from non-gated and ECG-gated chest CTs in 2053 Multi-Ethnic Study of Atherosclerosis (MESA) Exam 5 participants using mean and standard-deviation of absolute differences, intraclass correlation coefficients (ICC), and Cohen's κ. Variability between paired ECG-gated scans was determined by analyzing scans acquired 2 min apart in 5749 MESA Exam 1 participants. Predictive performance for incident HF and AF was compared using cumulative incidence curves, age- and sex-adjusted C-indices, and non-inferiority testing (δ=0.05). Results: Non-gated scans demonstrated excellent overall agreement with ECG-gated scans, with comparable performance for detecting cardiac chamber enlargement (98.8-99.2%, κ=0.76-0.84), relative to agreement observed between paired ECG-gated scans (98.6-98.9%, κ=0.72-0.77). Cumulative incidence curves for HF and AF stratified by quartiles showed substantial overlap. Age- and sex-adjusted C-indices were comparable for left atrial volume (0.75 vs 0.74, Conclusion: AI-based evaluation of non-gated chest CT may provide reliable cardiac chamber volumetry and cardiovascular outcome prediction, enabling opportunistic screening for HF and AF risk.
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