{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T06:15:27Z","timestamp":1771913727563,"version":"3.50.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Attenuation is correlated with the concentration of contrast medium (CM) in the arteries. The cardiac output (CO) affects the concentration of CM in the circulatory system; therefore, CO affects the time\u2013density curve (TDC). Thus, estimating CO using TDC from test-bolus images acquired in computed tomography (CT) is possible. In this study, we compare two methods of estimating CO, namely, an individualized mathematical compartment model, integrating patient, contrast, and scanning factors with TDC, and the Stewart\u2013Hamilton method based on the area under the curve of the TDC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Attenuation in the aorta was measured during test-bolus in 40 consecutive patients with a clinical indication for coronary CT angiography (CCTA). Each participant underwent cardiac magnetic resonance imaging following CCTA to validate the estimated CO. The individual compartment model used TDC in conjunction with scanning and patient-specific parameters to estimate the concentration of CM and CO over time. This was compared to the CO calculated from the area under the curve using the Stewart\u2013Hamilton method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both CO estimated with our individualized compartment model (<jats:italic>r<\/jats:italic>\u2009=\u20090.66, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01) and the Stewart\u2013Hamilton method (<jats:italic>r<\/jats:italic>\u2009=\u20090.53, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.01) were moderately correlated with CO measured with cardiac MRI. Body surface area (BSA) and time to peak (TTP) affected the accuracy of our model. Lower BSA resulted in overestimation, and lower TTP resulted in CO underestimation, respectively. We found no gender-specific difference in the accuracy of our model when correcting for BSA. The Stewart\u2013Hamilton method performed better with a more complete TDC, whereas the compartment model performed better overall with a partial TDC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TDC acquired in CCTA allows for CO estimation. Both the Stewart\u2013Hamilton method and our mathematical compartment model show moderate correlation when applied to our data, although each method has its strengths and limitations. If the majority of the TDC is known, the Stewart\u2013Hamilton method may be more reliable, but an individual compartment model is preferable when there are insufficient data points in the TDC. Regardless, both methods can potentially increase the diagnostic information acquired from a CCTA, which is increasingly recommended in clinical guidelines.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1156332","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T04:39:46Z","timestamp":1700455186000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating cardiac output from coronary CT angiography: an individualized compartment model in comparison to the Stewart\u2013Hamilton method"],"prefix":"10.3389","volume":"10","author":[{"given":"Jon Bjarne","family":"Leiknes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aksel","family":"Hiorth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorunn","family":"Havnen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole Jacob","family":"Greve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathinka D\u00e6hli","family":"Kurz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alf Inge","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacc.2018.08.2205","volume-title":"Coronary CT angiography in new-onset stable chest pain: time for US guidelines to be NICEr","author":"Blaha","year":"2019"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1016\/S0140-6736(15)60291-4","article-title":"CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial","volume":"385","year":"2015","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.jcct.2019.08.009","article-title":"Noninvasive assessment of coronary atherosclerosis by cardiac computed tomography for risk stratifying patients with suspected coronary heart disease","volume":"13","author":"van Rosendael","year":"2019","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.ijcard.2020.08.091","article-title":"Where ISCHEMIA fails, coronary CTA shines","volume":"322","author":"Lakshmanan","year":"2021","journal-title":"Int J Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1148\/radiol.10090908","article-title":"Intravenous contrast medium administration and scan timing at CT: considerations and approaches","volume":"256","author":"Bae","year":"2010","journal-title":"Radiology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.jcct.2009.02.008","article-title":"High-pitch spiral acquisition: a new scan mode for coronary CT angiography","volume":"3","author":"Achenbach","year":"2009","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"B12","DOI":"10.1093\/eurheartj\/suu024","article-title":"Routine low-radiation-dose coronary computed tomography angiography","volume":"16","author":"Al-Mallah","year":"2014","journal-title":"Eur Heart J Suppl"},{"key":"B8","doi-asserted-by":"publisher","first-page":"304","DOI":"10.2174\/1573403X15666190222163737","article-title":"Low-dose radiation advances in coronary computed tomography angiography in the diagnosis of coronary artery disease","volume":"15","author":"Richards","year":"2019","journal-title":"Curr Cardiol Rev"},{"key":"B9","doi-asserted-by":"publisher","first-page":"100318","DOI":"10.1016\/j.ajpc.2022.100318","article-title":"Cardiac CT angiography in current practice: an American Society for Preventive Cardiology clinical practice statement","volume":"9","author":"Budoff","year":"2022","journal-title":"Am J Prev Cardiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1148\/radiology.207.3.9609887","article-title":"Aortic and hepatic contrast medium enhancement at CT. 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