1
|
Takaoka H, Kitahara H, Ota J, Suzuki-Eguchi N, Sasaki H, Mori N, Takahashi M, Iida Y, Matsuura K, Nakayama T, Matsumiya G, Kobayashi Y. Utility of computed tomography in cases of aortic valve stenosis before and after transcatheter aortic valve implantation. Cardiovasc Interv Ther 2019; 35:72-84. [PMID: 31512054 DOI: 10.1007/s12928-019-00618-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/29/2019] [Indexed: 01/04/2023]
Abstract
Trans-catheter aortic valve implantation (TAVI) has been recognized as a useful treatment for patients with severe aortic valve stenosis, particularly those with moderate to high risks of open heart surgery. A thorough evaluation of the aortic valve complex, including the size or presence of calcifications of the leaflets and annulus, is important for the selection of appropriate candidates, artificial valve types and approach. Echocardiography is useful for the precise evaluation of aortic valve stenosis severity and aortic valve complex morphology, but it is not useful to evaluate three-dimensional aortic valve anatomy and pathway for the catheter of aortic valve implantation. Electrocardiography (ECG)-gating computed tomography (CT) has recently been recognized as a useful modality for evaluating significant coronary artery stenosis because of its higher spatial and temporal resolution and diagnostic accuracy based on recent studies. ECG-gating CT is also useful for evaluating aortic valve complex morphology, including calcifications and whole aorta and iliac arteries, as the access route of catheter in TAVI. TAVI candidates, who are at high risk of open surgery, tend to be old and require anti-platelet after TAVI; therefore CT, is also useful for screening for non-cardiac diseases including malignant tumors just before TAVI. Therefore, here we introduce the utility of cardiac and whole body CT in cases of severe aortic valve stenosis before and after TAVI.
Collapse
Affiliation(s)
- Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan.
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Joji Ota
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Noriko Suzuki-Eguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Haruka Sasaki
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Naoto Mori
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Manami Takahashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Yasunori Iida
- Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan
| | - Kaoru Matsuura
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takashi Nakayama
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| | - Goro Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Inohana 1-8-1, Cuo-ku, Chiba, Japan
| |
Collapse
|
2
|
Mushtaq S, Pontone G, Conte E, Guglielmo M, Consiglio E, Magatelli M, Oliveira M, Muscogiuri G, Annoni A, Baggiano A, Formenti A, Mancini ME, Di Odoardo L, Melotti E, Fiorentini C, Bartorelli AL, Pepi M, Andreini D. Low-Dose Coronary CT Angiography in Patients with Atrial Fibrillation: Comparison of Image Quality and Radiation Exposure with Two Different Approaches. Acad Radiol 2019; 26:791-797. [PMID: 30093216 DOI: 10.1016/j.acra.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate image quality, coronary interpretability and radiation exposure of coronary CT angiography (CCTA) performed in patients with atrial fibrillation (AF) with the latest scanner generation, comparing two different technical approaches. A new scanner that combines a 0.23 mm spatial resolution, a new generation of iterative reconstruction, fast gantry rotation time and the intracycle motion-correction algorithm to improve the temporal resolution was recently introduced in the clinical field. MATERIALS AND METHODS We enrolled 105 consecutive patients with chronic AF who performed CCTA with a whole-heart coverage high-definition CT scanner (16-cm z-axis coverage with 256 detector rows, 0.28 s gantry rotation time). Five of them were excluded for impaired renal function. Patients were randomized between a double acquisition protocol (50 patients, group 1) or a single acquisition protocol (50 patients, group 2). The image quality, coronary segment interpretability and effective dose (ED) of CCTA were assessed. RESULTS The mean HR during the scan was 85.6±21 bpm in group 1 vs. 83.7±23 bpm in Group 2, respectively (p < ns). In group 2, overall image quality was high and comparable with that of group 1 (Likert scale =3.2 ± 1.4 vs. 3.3 ± 1.2, p = ns, in group 1 and 2, respectively). Coronary interpretability was high and similar between the two groups (97.5% and 97.1% in group 1 and 2, p = ns, respectively). Mean ED was significantly higher in group 1 than in group 2 (5.3 ± 1.8 mSv vs. 2.7 ± 0.7 mSv, p < 0.001). CONCLUSION The novel whole-heart coverage CT scanner allows to perform CCTA with a single-acquisition protocol with high image quality and low radiation exposure in AF patients.
Collapse
Affiliation(s)
- Saima Mushtaq
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Gianluca Pontone
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Edoardo Conte
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Marco Guglielmo
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Elisa Consiglio
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Marco Magatelli
- Cardiology Department, University and ASST Spedali Civili, Brescia, Italy
| | - Margarida Oliveira
- Cardiology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | | | - Andrea Annoni
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Andrea Baggiano
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Alberto Formenti
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | | | - Luca Di Odoardo
- Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Eleonora Melotti
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Cesare Fiorentini
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Antonio L Bartorelli
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy
| | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy
| | - Daniele Andreini
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
| |
Collapse
|
3
|
Hamaoka T, Murai H, Kaneko S, Usui S, Inoue O, Sugimoto H, Mukai Y, Okabe Y, Tokuhisa H, Takashima S, Kato T, Furusho H, Kashiwaya S, Sugiyama Y, Nakatsumi Y, Takata S, Takamura M. Significant Association Between Coronary Artery Low-Attenuation Plaque Volume and Apnea-Hypopnea Index, But Not Muscle Sympathetic Nerve Activity, in Patients With Obstructive Sleep Apnea Syndrome. Circ J 2018; 82:2852-2860. [DOI: 10.1253/circj.cj-18-0237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takuto Hamaoka
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Hisayoshi Murai
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Shuichi Kaneko
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Soichiro Usui
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Oto Inoue
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Hiroyuki Sugimoto
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Yusuke Mukai
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Yoshitaka Okabe
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Hideki Tokuhisa
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Shinichiro Takashima
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Takeshi Kato
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | - Hiroshi Furusho
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| | | | | | | | | | - Masayuki Takamura
- System Biology, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University
| |
Collapse
|
4
|
Korosoglou G, Marwan M, Giusca S, Schmermund A, Schneider S, Bruder O, Hausleiter J, Schroeder S, Leber A, Limbourg T, Gitsioudis G, Rixe J, Zahn R, Katus HA, Achenbach S, Senges J. Influence of irregular heart rhythm on radiation exposure, image quality and diagnostic impact of cardiac computed tomography angiography in 4,339 patients. Data from the German Cardiac Computed Tomography Registry. J Cardiovasc Comput Tomogr 2017; 12:34-41. [PMID: 29195843 DOI: 10.1016/j.jcct.2017.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 10/22/2017] [Accepted: 11/16/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Coronary computed tomography angiography (coronary CTA) provides non-invasive evaluation of the coronary arteries with high precision for the detection of significant coronary artery disease (CAD). AIM To investigate whether irregular heart rhythm including atrial fibrillation and premature beats during data acquisition influences (i) radiation and contrast media exposure, (ii) number of non-evaluable coronary segments and (iii) diagnostic impact of coronary CTA. METHODS Twelve tertiary care centers with ≥64 slice CT scanners and ≥5 years of experience with cardiovascular imaging participated in this registry. Between 2009 and 2014, 4339 examinations were analysed in patients who underwent clinically indicated coronary CTA for suspected CAD. Clinical and epidemiologic data were gathered from all patients. In addition, clinical presentation, heart rate and rhythm during the scan, Agatston score, radiation and contrast media exposure and the diagnostic impact of coronary CTA were systematically analysed. RESULTS Of 4339 patients in total, 260 (6.0%) had irregular heart rhythm, whereas the remaining 4079 (94.0%) had stable sinus rhythm. Patients with irregular heart rhythm were older (63.2 ± 12.5yrs versus 58.6 ± 11.4yrs. p < 0.001), exhibited a higher rate of pathologic stress tests before CTA (37.1% versus 26.1%, p < 0.01) and higher heart rates during CTA compared to those with sinus rhythm (62.5 ± 11.6bpm versus 58.9 ± 8.5bpm, p < 0.001). Both contrast media exposure and radiation exposure were significantly higher in patients with irregular heart rhythm (90 mL (95%CI = 80-110 mL) versus 80 mL (95%CI = 70-90 mL) and 6.2 mSv (95%CI = 2.5-11.7) versus 3.3 mSv (95%CI = 1.7-6.9), p < 0.001 for both). Coronary CTA excluded significant CAD less frequently in patients with irregular heart rhythm (32.9% versus 44.8%, p < 0.001). This was attributed to the higher rate of examinations with at least one non-diagnostic coronary segment in patients with irregular heart rhythm (10.8% versus 4.6%, p < 0.001). Subsequent invasive angiography could be avoided in 47.2% of patients with irregular heart rhythm compared to 52.9% of patients with sinus rhythm (p = NS), whereas downstream stress testing was recommended in 3.2% of patients with irregular heart rhythm versus 4.0% of patients with sinus rhythm (p = NS). CONCLUSION A significant number of patients scheduled for coronary CTA have irregular heart rhythm in a real-world clinical setting. In such patients, heart rate during coronary CTA is higher, possibly resulting in (i) higher radiation and contrast agent exposure and (ii) more frequent coronary CTA examinations with at least one non-diagnostic coronary artery segment. However, this does not seem to lead to increased downstream stress testing or subsequent invasive procedures.
Collapse
Affiliation(s)
- Grigorios Korosoglou
- Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany..
| | - Mohamed Marwan
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nuernberg, Erlangen, Germany
| | - Sorin Giusca
- Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany
| | - Axel Schmermund
- Cardiovascular Center Bethanien (CCB), Frankfurt Am Main, Germany
| | | | | | - Jörg Hausleiter
- Department of Cardiology, Ludwig-Maximilian's University, Munich, Germany
| | - Stephen Schroeder
- Department of Cardiology and Pneumology, Alb Fils Clinics, Geislingen, Germany
| | | | - Tobias Limbourg
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - Gitsios Gitsioudis
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nuernberg, Erlangen, Germany
| | - Johannes Rixe
- Department of Cardiology, University of Giessen, Giessen, Germany
| | - Ralf Zahn
- Department of Cardiology, Ludwigshafen, Germany
| | - Hugo A Katus
- Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nuernberg, Erlangen, Germany
| | - Jochen Senges
- Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
| |
Collapse
|
5
|
Computed tomography is important in appropriately diagnosing patients with third-degree atrioventricular block and second-degree atrioventricular block but not Wenckebach type. Int J Cardiol 2017; 228:700-706. [DOI: 10.1016/j.ijcard.2016.11.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/06/2016] [Indexed: 11/21/2022]
|
6
|
Multisector-reconstruction in 1st generation 320-slice CT at high pulsation-rates achieved accurate-evaluation of coronary-lumen patency after insertion of a XIENCE stent. XIENCE Phantom Study Part 4. Int J Cardiol 2016; 202:509-10. [PMID: 26440463 DOI: 10.1016/j.ijcard.2015.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/19/2015] [Indexed: 11/24/2022]
|
7
|
Clayton B, Roobottom C, Morgan-Hughes G. CT coronary angiography in atrial fibrillation: a comparison of radiation dose and diagnostic confidence with retrospective gating vs prospective gating with systolic acquisition. Br J Radiol 2015; 88:20150533. [PMID: 26337604 DOI: 10.1259/bjr.20150533] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare unmodulated, retrospective electrocardiographic (ECG) gating to prospective ECG gating with systolic acquisition for CT coronary angiography (CTCA) in patients with atrial fibrillation (AF), considering the radiation dose and the diagnostic confidence achieved with each technique. METHODS A retrospective service evaluation was conducted before and after prospective gating with systolic acquisition replaced retrospectively gated imaging for patients with AF undergoing CTCA at our institution. 25 consecutive patients were examined in each group. The scan parameters and radiation dose information had been collected in a prospective fashion. The image sets were read by blinded, expert readers who rated their diagnostic confidence using a 5-point Likert scale. RESULTS The radiation dose received by patients was significantly greater in the retrospectively gated group than those being scanned using prospective gating (21 vs 5.9 mSv, p < 0.01). The prospective gating technique was also associated with greater diagnostic confidence (mean, per-patient score 3.09 vs 3.78, p = 0.02). CONCLUSION Prospective gating with systolic acquisition appears to improve diagnostic confidence at a significantly reduced radiation dose compared with retrospective gating in patients with AF. ADVANCES IN KNOWLEDGE The use of prospective gating with systolic triggering significantly reduces the radiation exposure to patients in AF undergoing CTCA. The same protocol also appears to improve diagnostic confidence.
Collapse
Affiliation(s)
| | - Carl Roobottom
- 2 Radiology Department, Derriford Hospital, Plymouth, UK
| | | |
Collapse
|
8
|
Yang L, Xu L, Schoepf UJ, Wichmann JL, Fox MA, Yan J, Fan Z, Zhang Z. Prospectively ECG-Triggered Sequential Dual-Source Coronary CT Angiography in Patients with Atrial Fibrillation: Influence of Heart Rate on Image Quality and Evaluation of Diagnostic Accuracy. PLoS One 2015. [PMID: 26221952 PMCID: PMC4519310 DOI: 10.1371/journal.pone.0134194] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives To evaluate the effects of mean heart rate (HR) and heart rate variation (HRV) on image quality and diagnostic accuracy of prospectively ECG-triggered sequential dual-source coronary CT angiography (CCTA) in patients with atrial fibrillation (AF). Methods Eighty-five patients (49 women, 36 men; mean age 62.1±9.5 years) with persistent AF underwent prospectively ECG-triggered sequential second-generation dual-source CCTA. Tube current and voltage were adjusted according to body mass index (BMI) and iterative reconstruction was used. Image quality of coronary segments (four-point scale) and presence of significant stenosis (>50%) were evaluated. Diagnostic accuracy was analyzed in 30 of the 85 patients who underwent additional invasive coronary angiography (ICA). Results Only 8 of 1102 (0.7%) segments demonstrated poor image quality. No significant impact on image quality was found for mean HR (94.9±21.8 bpm; r=0.034, p=0.758; F=0.413, p=0.663) or HRV (67.5±22.8 bpm; r=0.097, p=0.377; F=0.111, p=0.895). On per-segment analysis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 89.7% (26/29), 99.4% (355/357), 92.9% (26/28), and 99.2% (355/358), respectively, with excellent correlation (kappa=0.91) with ICA. Mean effective dose was 3.3±1.0 mSv. Conclusions Prospectively ECG-triggered sequential dual-source CCTA provides diagnostic image quality and good diagnostic accuracy for detection of coronary stenosis in AF patients without significant influence by HR or HRV.
Collapse
Affiliation(s)
- Lin Yang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- * E-mail:
| | - U. Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States of America
| | - Julian L. Wichmann
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States of America
| | - Mary A. Fox
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, United States of America
| | - Jing Yan
- Siemens Healthcare China, 278 Zhouzhu Road, Shanghai, China
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhaoqi Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
9
|
Coronary computed tomography angiography for the assessment of chest pain: current status and future directions. Int J Cardiovasc Imaging 2015; 31 Suppl 2:125-43. [DOI: 10.1007/s10554-015-0698-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 02/02/2023]
|
10
|
Di Cesare E, Gennarelli A, Di Sibio A, Felli V, Splendiani A, Gravina GL, Masciocchi C. Image quality and radiation dose of single heartbeat 640-slice coronary CT angiography: A comparison between patients with chronic Atrial Fibrillation and subjects in normal sinus rhythm by propensity analysis. Eur J Radiol 2015; 84:631-6. [DOI: 10.1016/j.ejrad.2014.11.035] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 11/07/2014] [Accepted: 11/30/2014] [Indexed: 10/24/2022]
|
11
|
Uehara M, Funabashi N, Takaoka H, Ozawa K, Kobayashi Y. The CHADS2 score is a useful predictor of coronary arteriosclerosis on 320 slice CT and may correlate with prognosis in subjects with atrial fibrillation. Int J Cardiol 2015; 179:84-9. [DOI: 10.1016/j.ijcard.2014.10.151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 09/29/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
|
12
|
Funabashi N, Uehara M, Takaoka H, Ozawa K, Kushida S, Kanda J, Fujimoto Y, Kobayashi Y. A two center 320 slice CT study for evaluating coronary arteries in subjects with chronic atrial fibrillation: A comparison of prospective and retrospective ECG-gating acquisition. Int J Cardiol 2014; 177:374-9. [DOI: 10.1016/j.ijcard.2014.07.126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/26/2014] [Indexed: 10/24/2022]
|
13
|
CHA2DS2-VASc score is a useful-predictor of not prognosis but coronary-arteriosclerosis in chronic atrial-fibrillation compared with CHADS2 score: A two-center study of 320-slice CT, part 2. Int J Cardiol 2014; 177:368-73. [DOI: 10.1016/j.ijcard.2014.07.128] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 07/26/2014] [Indexed: 11/21/2022]
|
14
|
Coronary CT Angiography in Patients with Atrial Fibrillation. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9274-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
15
|
Kakuta K, Dohi K, Yamada T, Yamanaka T, Kawamura M, Nakamori S, Nakajima H, Tanigawa T, Onishi K, Yamada N, Nakamura M, Ito M. Detection of coronary artery disease using coronary flow velocity reserve by transthoracic Doppler echocardiography versus multidetector computed tomography coronary angiography: influence of calcium score. J Am Soc Echocardiogr 2014; 27:775-85. [PMID: 24679739 DOI: 10.1016/j.echo.2014.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND There have been no clinical data specifying the degree of calcium deposition at which coronary flow velocity reserve (CFVR) measurement using transthoracic Doppler echocardiography surpasses 320-row multidetector computed tomographic coronary angiography (CTCA) in detecting obstructive coronary artery disease. METHODS One hundred seventy patients who underwent invasive coronary angiography, transthoracic Doppler echocardiography, and CTCA were prospectively enrolled. Coronary artery stenosis was defined as percentage diameter stenosis ≥ 50% on invasive coronary angiography. CFVR < 2.0 and narrowing ≥ 50% measured with CTCA were the thresholds indicating the presence of coronary artery stenosis. The degree of coronary artery calcification was also assessed using the Agatston calcium score method by computed tomography. RESULTS The majority of patients (89%) were classified as having either high or intermediate pretest probability of coronary artery disease. Significant coronary artery stenoses by invasive coronary angiography were found in 71 patients and 104 vessels. Although the overall diagnostic performance of CTCA was comparable with that of CFVR measurement for detecting coronary artery stenosis, only the diagnostic performance of CTCA was negatively affected by the extent of a patient's coronary artery calcification. Receiver operating characteristic curve analysis indicated that only CFVR measurement is diagnostically accurate when calcium scores are >319 in the patient-based assessment, 189 for the left anterior descending coronary artery, 98 for the left circumflex coronary artery and 282 for the right coronary artery. CONCLUSIONS Transthoracic Doppler echocardiography and 320-row multidetector CTCA successfully diagnosed significant coronary artery stenosis with high feasibility and accuracy. However, only the diagnostic performance of CTCA was negatively affected by the extent of a patient's coronary artery calcification, and therefore the diagnostic performance of CFVR measurement for detecting coronary artery stenosis surpassed that of CTCA when the calcium score exceeded specified cutoff values.
Collapse
Affiliation(s)
- Kentaro Kakuta
- Department of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
| | - Tomomi Yamada
- Department of Translational Medical Science, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takashi Yamanaka
- Department of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan
| | - Masaki Kawamura
- Department of Cardiology, Yokkaichi Social Insurance Hospital, Yokkaichi, Japan
| | - Shiro Nakamori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Nakajima
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Takashi Tanigawa
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Katsuya Onishi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Norikazu Yamada
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mashio Nakamura
- Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| |
Collapse
|
16
|
Ozawa K, Funabashi N, Takaoka H, Uehara M, Ueda M, Murakawa Y, Kobayashi Y. Various morphological-types of all and fragmented ventricular premature beats on a 12-lead Holter-ECG had positive-relationship with occurrence of LV fibrosis on CT in HCM subjects. Int J Cardiol 2014; 171:450-6. [PMID: 24342412 DOI: 10.1016/j.ijcard.2013.11.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/23/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Koya Ozawa
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | - Hiroyuki Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Masae Uehara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Marehiko Ueda
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Yuji Murakawa
- The 4th Department of Internal Medicine, Teikyo University School of Medicine, Mizonokuchi Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki 213-8507, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| |
Collapse
|
17
|
Prospective ECG-Gated Coronary 320-MDCT Angiography With Absolute Acquisition Delay Strategy for Patients With Persistent Atrial Fibrillation. AJR Am J Roentgenol 2013; 201:1197-203. [DOI: 10.2214/ajr.12.10140] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
18
|
Ozawa K, Funabashi N, Tanabe N, Yanagawa N, Tatsumi K, Kataoka A, Kobayashi Y. Detection of right ventricular wall motion asynergy confirmed on four-dimensional 320-slice CT by two-dimensional global longitudinal strain of right ventricle using transthoracic-echocardiography in pulmonary hypertension. Int J Cardiol 2013; 169:e70-4. [DOI: 10.1016/j.ijcard.2013.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 09/27/2013] [Indexed: 11/15/2022]
|
19
|
Distinguishing 320 slice CT-detected focal fibrotic lesions and non-fibrotic lesions in hypertrophic cardiomyopathy by assessment of regional myocardial strain using two dimensional speckle tracking echocardiography. Int J Cardiol 2013; 169:e109-13. [PMID: 24182677 DOI: 10.1016/j.ijcard.2013.10.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/02/2013] [Accepted: 10/07/2013] [Indexed: 11/20/2022]
|
20
|
Linde JJ, Kofoed KF, Sørgaard M, Kelbæk H, Jensen GB, Nielsen WB, Hove JD. Cardiac computed tomography guided treatment strategy in patients with recent acute-onset chest pain. Int J Cardiol 2013; 168:5257-62. [DOI: 10.1016/j.ijcard.2013.08.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/25/2013] [Accepted: 08/03/2013] [Indexed: 10/26/2022]
|
21
|
Takaoka H, Funabashi N, Uehara M, Fujimoto Y, Kobayashi Y. Diagnostic accuracy of coronary 320 slice CT angiography using retrospective electrocardiogram gated acquisition compared with virtual prospective electrocardiogram gated acquisition with and without padding. Int J Cardiol 2013; 168:2811-5. [DOI: 10.1016/j.ijcard.2013.03.066] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 03/06/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
|
22
|
Risk stratification using myocardial peak longitudinal-strain on speckle-tracking transthoracic-echocardiogram to predict major adverse cardiac events in non ischemic hypertrophic-cardiomyopathy subjects confirmed by MDCT. Int J Cardiol 2013; 168:4586-9. [DOI: 10.1016/j.ijcard.2013.06.056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 05/19/2013] [Accepted: 06/30/2013] [Indexed: 11/21/2022]
|
23
|
Nakamura K, Funabashi N, Naito S, Uehara M, Takaoka H, Kaseno K, Kumagai K, Oshima S, Kobayashi Y. Anatomical relationship of coronary sinus/great cardiac vein and left circumflex coronary artery along mitral annulus in atrial fibrillation before radiofrequency catheter ablation using 320-slice CT. Int J Cardiol 2013; 168:5174-81. [DOI: 10.1016/j.ijcard.2013.07.261] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 07/20/2013] [Indexed: 10/26/2022]
|
24
|
Uehara M, Funabashi N, Takaoka H, Fujimoto Y, Kuroda N, Kobayashi Y. Detection of luminal stenosis by 320-slice CT in coronary arteries with cross-sectional area less than 4mm2 confirmed by intravascular-ultrasound compared with conventional coronary angiography. Int J Cardiol 2013; 168:5457-60. [DOI: 10.1016/j.ijcard.2013.07.170] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 05/18/2013] [Accepted: 07/20/2013] [Indexed: 10/26/2022]
|
25
|
Funabashi N, Kataoka A, Uehara M, Takaoka H, Kabasawa M, Takahashi M, Kanaeda A, Kobayashi Y. Relationship of maximum and minimum tricuspid valve annular diameter determined by 320-slice ct with right atrial and ventricular volume and estimated right ventricular systolic pressure. Int J Cardiol 2013; 168:4578-81. [DOI: 10.1016/j.ijcard.2013.06.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Revised: 05/18/2013] [Accepted: 06/30/2013] [Indexed: 12/01/2022]
|
26
|
Takaoka H, Funabashi N, Kataoka A, Uehara M, Umazume T, Matsumiya G, Kabasawa M, Fujimoto Y, Kobayashi Y. Utilities of 320-slice computed-tomography for evaluation of tricuspid valve annular diameter before tricuspid-valve-plasty compared with the direct-measurement of tricuspid valve annular diameter during open heart-surgery. Int J Cardiol 2013; 168:2889-93. [DOI: 10.1016/j.ijcard.2013.03.097] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 03/29/2013] [Indexed: 11/25/2022]
|
27
|
Specific organized substrates of ventricular fibrillation: Comparison of 320-slice CT heart images in non-ischemic ventricular fibrillation subjects with non-ischemic sustained and non-sustained ventricular tachycardia subjects. Int J Cardiol 2013; 168:1472-8. [DOI: 10.1016/j.ijcard.2012.12.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 12/15/2012] [Accepted: 12/24/2012] [Indexed: 02/01/2023]
|
28
|
Pre-operative CT coronary angiography in patients with mitral valve prolapse referred for surgical repair: Comparison of accuracy, radiation dose and cost versus invasive coronary angiography. Int J Cardiol 2013; 167:2889-94. [DOI: 10.1016/j.ijcard.2012.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 06/29/2012] [Accepted: 07/21/2012] [Indexed: 11/21/2022]
|
29
|
Uehara M, Takaoka H, Ozawa K, Kobayashi Y, Funabashi N. Clinical significance of fat infiltration in the moderator band and right ventricular myocardium in multislice CT, and its association with abnormal conduction seen in electrocardiogram. Int J Cardiol 2013; 168:352-6. [DOI: 10.1016/j.ijcard.2012.09.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 09/07/2012] [Accepted: 09/15/2012] [Indexed: 11/16/2022]
|
30
|
Funabashi N, Irie R, Aiba M, Morimoto R, Kabashima T, Fujii S, Uehara M, Ozawa K, Takaoka H, Kobayashi Y. Adaptive-Iterative-Dose-Reduction 3D with multisector-reconstruction method in 320-slice CT may maintain accurate-measurement of the Agatston-calcium-score of severe-calcification even at higher pulsating-beats and low tube-current in vitro. Int J Cardiol 2013; 168:601-3. [DOI: 10.1016/j.ijcard.2013.01.230] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 01/18/2013] [Indexed: 11/27/2022]
|
31
|
Myocardial fibrosis in the right ventricle detected on ECG gated 320 slice CT showed a short term poor prognosis in subjects with pulmonary hypertension. Int J Cardiol 2013; 168:584-6. [DOI: 10.1016/j.ijcard.2013.01.251] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 01/18/2013] [Indexed: 11/18/2022]
|
32
|
Funabashi N, Umazume T, Takaoka H, Kataoka A, Ozawa K, Uehara M, Kobayashi Y. Sigmoid shaped interventricular septum exhibit normal myocardial characteristics and has a relationship with aging, ascending aortic sclerosis and its tilt to left ventricle. Int J Cardiol 2013; 168:4484-8. [PMID: 23915525 DOI: 10.1016/j.ijcard.2013.06.129] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 06/30/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Nobusada Funabashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
| | | | | | | | | | | | | |
Collapse
|
33
|
Vorre MM, Abdulla J. Diagnostic Accuracy and Radiation Dose of CT Coronary Angiography in Atrial Fibrillation: Systematic Review and Meta-Analysis. Radiology 2013; 267:376-86. [DOI: 10.1148/radiol.13121224] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
34
|
Li S, Ni Q, Wu H, Peng L, Dong R, Chen L, Liu J. Diagnostic accuracy of 320-slice computed tomography angiography for detection of coronary artery stenosis: meta-analysis. Int J Cardiol 2013; 168:2699-705. [PMID: 23566493 DOI: 10.1016/j.ijcard.2013.03.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 01/26/2013] [Accepted: 03/17/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aims to review the recent literatures on the diagnostic accuracy of 320-slice computed tomography angiography (CTA) for detection of coronary artery stenosis, with invasive coronary angiography (ICA) as the reference standard. METHODS A PubMed and EMBASE cross-search of the literatures on use of 320-slice CTA compared with ICA for detection of coronary artery stenosis, with publication date limited to January 1, 2008 to December 31, 2012. Individual and pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated at the patient-, vessel- and segment-level. A positive result was defined as greater than or equal to 50%-diameter stenosis. RESULTS A total of ten studies were included in the present meta-analysis, examining 1088 patients, 1629 vessels and 12,406 segments. The meta-analysis at the patient-level indicated a pooled sensitivity of 93% (95%CI: 91%-95%), specificity of 86% (95%CI: 82%-89%), PPV of 90% (95%CI: 87%-92%) and NPV of 90% (95%CI: 87%-93%). At the vessel-level, the pooled sensitivity was 92% (95%CI: 89%-94%), specificity 95% (95%CI: 94%-96%), PPV 87% (95%CI: 83%-90%), and NPV 97% (95%CI: 96%-98%). At the segment-level, the pooled sensitivity was 78% (95%CI: 76%-80%), specificity 98% (95%CI: 97%-98%), PPV 82% (95%CI: 80%-84%), and NPV 97% (95%CI: 97%-97%). CONCLUSIONS 320-CTA can effectively identify the majority of patients with coronary artery disease (CAD). The high NPV makes it as an effective noninvasive alternative to ICA for the exclusion of stenosis.
Collapse
Affiliation(s)
- Suhua Li
- Department of Cardiology, The Third Affiliated Hospital, Sun Yat-sen University, Tian-he Road, Guangzhou 510630, China
| | | | | | | | | | | | | |
Collapse
|
35
|
Wang Q, Qin J, He B, Zhou Y, Yang JJ, Hou XL, Yang XB, Chen JH, Chen YD. Computed tomography coronary angiography with a consistent dose below 2 mSv using double prospectively ECG-triggered high-pitch spiral acquisition in patients with atrial fibrillation: initial experience. Int J Cardiovasc Imaging 2013; 29:1341-9. [PMID: 23471682 DOI: 10.1007/s10554-013-0203-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 03/01/2013] [Indexed: 02/03/2023]
Abstract
To evaluate the feasibility and imaging quality of double prospectively ECG-triggered high-pitch spiral acquisition mode (double flash mode) for coronary computed tomography angiography (CTCA) in patients with atrial fibrillation (AF). 47 patients (11 women, 36 men; mean age 64.5 ± 12.1 years) were enrolled for CTCA examinations using a dual-source CT with 2 × 128 × 0.6 mm collimation, 0.28 s rotation time and a pitch of 3.4. Double flash mode was prospectively triggered first at 60 % and later at 30 % of the R-R interval within two cardiac cycles. Image quality was evaluated using a four-point scale (1 = excellent, 4 = non-assessable). From 672 coronary artery segments, 77.5 % (521/672) was rated as score of 1, 20.8 % (140/672) as score of 2, 1.2 % (8/672) as score of 3 and 0.4 % (3/672) was rated as 'non-assessable'. The average image quality score was 1.25 ± 0.38 on a per segment basis. Mean dose-length product for CTCA was 92.6 ± 28.2 mGy cm, the effective dose was 1.30 ± 0.39 mSv (0.64-1.97 mSv). In patients with AF, double prospectively ECG-triggered high-pitch spiral acquisition mode could be a feasible and valuable scan mode for CTCA with a consistent dose below 2 mSv as well as diagnostic imaging quality.
Collapse
Affiliation(s)
- Qi Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, 100853, China.
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Srichai MB, Barreto M, Lim RP, Donnino R, Babb JS, Jacobs JE. Prospective-triggered sequential dual-source end-systolic coronary CT angiography for patients with atrial fibrillation: a feasibility study. J Cardiovasc Comput Tomogr 2013; 7:102-9. [PMID: 23545461 DOI: 10.1016/j.jcct.2013.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/04/2013] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Obtaining diagnostic coronary CT angiography with low radiation exposure in patients with irregular heart rhythms such as atrial fibrillation (AF) remains challenging. OBJECTIVE We evaluated image quality and inter-reader variability with the use of prospective electrocardiographic (ECG)-triggered sequential dual-source acquisition at end systole for coronary artery disease (CAD) evaluation in patients with AF. METHODS Thirty consecutive patients with AF who underwent prospective ECG-triggered sequential dual-source acquisition were evaluated. Images were reconstructed every 50 milliseconds from 250 to 400 milliseconds after the R wave. Two independent, blinded readers evaluated the coronaries for image quality on a 5-point scale (worst to best) and stenosis on 5-point semiquantitative (none to severe) and binary scales (>50% or <50%). Diagnostic image quality was graded for each reconstruction. RESULTS Eleven patients (37%) had significant (≥50% stenosis) CAD. Average heart rate was 82 ± 20 beats/min and variability range was 71 ± 22 beats/min. Mean effective radiation dose was 6.5 ± 2.4 mSv. Diagnostic image quality was noted in 97.9% of 304 coronary segments with median image quality of 3.0. The 300-millisecond reconstruction phase provided the highest image quality; 70% of patients showed diagnostic image quality. Combination of all phases (250-400 milliseconds) performed significantly better than single or other phase combinations (P < 0.0005 for all comparisons). Inter-reader variability for stenosis detection was excellent, with 98.4% concordance by using a binary scale (50% stenosis cutoff). CONCLUSIONS Prospective ECG-triggered sequential dual-source CT acquisition with the use of end-systolic acquisition provides diagnostic image quality with potentially low radiation doses for evaluation of CAD in patients with AF. Use of multiple end-systolic phases over a 150-millisecond window improves diagnostic image quality.
Collapse
Affiliation(s)
- Monvadi B Srichai
- Department of Medicine, Cardiology Division, Medstar Georgetown University Hospital, 3800 Reservoir Road NW, 5PHC, Washington, DC 20007, USA.
| | | | | | | | | | | |
Collapse
|
37
|
Uehara M, Takaoka H, Kobayashi Y, Funabashi N. Diagnostic accuracy of 320-slice computed-tomography for detection of significant coronary artery stenosis in patients with various heart rates and heart rhythms compared with conventional coronary-angiography. Int J Cardiol 2012; 167:809-15. [PMID: 22429616 DOI: 10.1016/j.ijcard.2012.02.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 01/17/2012] [Accepted: 02/17/2012] [Indexed: 12/16/2022]
Abstract
PURPOSE To evaluate the diagnostic accuracy of 320-slice CT for detection of significant coronary artery stenosis in patients with various heart rates (HR) and heart rhythms, including tachycardia and chronic atrial-fibrillation (CAF) compared with conventional-coronary-angiography (CAG). MATERIALS AND METHODS One-hundred-six consecutive patients underwent both 320-slice CT and CAG within 3 months (normal-sinus-rhythm [NSR] 91.5%, CAF 8.5%, mean HR 65 ± 15 beats/min). There were no cardiac events between the 2 procedures. Patients were divided in 2 groups: Group 1 (HR <65 with NSR at CT scan, n=62), and Group 2 (HR >64 with NSR or heart rhythm irregularities at CT scan, n=44). Patients with >50% or >75% luminal stenosis on CT were compared with those with >50% or >75% stenosis on CAG, respectively. RESULTS In a segment-by-segment analysis, in all patients, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of >50% stenosis on CT for predicting >50% stenosis on CAG were 69, 98, 78, and 97%, respectively, and those of >75% stenosis on CT for predicting >75% stenosis on CAG were 78, 98, 64, and 99%, respectively. Sensitivity, specificity, PPV, and NPV of >50% and 75% stenosis on CT for predicting >50% and >75% stenosis, respectively, on CAG were comparable. Diagnostic accuracy was essentially the same in both groups. CONCLUSION 320-slice CT had high diagnostic accuracy for the detection of significant coronary artery stenosis compared with CAG. Even though the numbers were small, patients with high HR or heart rhythm irregularities might have essentially equivalent results to those with low HR with NSR.
Collapse
Affiliation(s)
- Masae Uehara
- Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | | | | | | |
Collapse
|
38
|
van der Wall EE, de Graaf FR, van Velzen JE, Jukema JW, Bax JJ, Schuijf JD. 320-row CT: does beat-to-beat motion of the coronary arteries affect image quality? Int J Cardiovasc Imaging 2011; 28:147-51. [PMID: 21279691 PMCID: PMC3275735 DOI: 10.1007/s10554-010-9794-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 12/30/2010] [Indexed: 11/24/2022]
Affiliation(s)
- E. E. van der Wall
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - F. R. de Graaf
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. E. van Velzen
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. W. Jukema
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. J. Bax
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| | - J. D. Schuijf
- Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, Leiden, The Netherlands
| |
Collapse
|