Objectives: Coronary computed tomography angiography (CCTA) has higher diagnostic accuracy than coronary artery calcium (CAC) score for detecting obstructive coronary artery disease (CAD) in patients with stable chest pain, while the added diagnostic value of combining CCTA with CAC is unknown. We investigated whether combining coronary CCTA with CAC score can improve the diagnosis of obstructive CAD compared with CCTA alone.
Methods: A total of 2315 patients (858 women, 37%) aged 61.
Objectives: There is conflicting evidence about the comparative diagnostic accuracy of the Agatston score versus computed tomography angiography (CTA) in patients with suspected obstructive coronary artery disease (CAD).
Purpose: To determine whether CTA is superior to the Agatston score in the diagnosis of CAD.
Methods: In total 2452 patients with stable chest pain and a clinical indication for invasive coronary angiography (ICA) for suspected CAD were included by the Collaborative Meta-analysis of Cardiac CT (COME-CCT) Consortium.
Background: The aim of the study is to investigate how well patients remember the radiologist's name after a radiological examination, and whether giving the patient a business card improves the patient's perception of the radiologist's professionalism and esteem.
Methods: In this prospective and randomized two-centre study, a total of 141 patients with BI-RADS 1 and 2 scores were included. After screening examination comprising mammography and ultrasound by a radiologist, 71 patients received a business card (group 1), while 70 received no business card (group 2).
Eur J Nucl Med Mol Imaging
September 2019
Background: Although women with cardiovascular disease experience relatively worse outcomes as compared to men, substantial knowledge gaps remain regarding the unique female determinants of cardiovascular risk. Heart rate (HR) responses to vasodilator stress mirror autonomic activity and may carry important long-term prognostic information in women.
Methods And Results: Hemodynamic changes during adenosine stress were recorded in a total of 508 consecutive patients (104 women) undergoing clinically indicated N-ammonia Positron-Emission-Tomography (PET) at our institution.
PLoS One
November 2019
Objectives: To assess the occurrence of transient interruption of contrast (TIC) phenomenon in pulmonary computed tomography angiography (CTPA) exams performed in inspiratory breath-hold after patients were told to inspire gently.
Methods: In this retrospective single-centre study, CTPA exams of 225 consecutive patients scanned on a 16-slice CT scanner system were analysed. A-priori to measurements, exams were screened for inadequate pulmonary artery contrast due to incorrect bolus tracking or failure of i.
The original version of this article, published on 19 March 2018, unfortunately contained a mistake. The following correction has therefore been made in the original: The names of the authors Philipp A. Kaufmann, Ronny Ralf Buechel and Bernhard A.
View Article and Find Full Text PDFPurpose: Evidence to date on the unique female determinants of cardiovascular risk is inadequate. Positron Emission Tomography (PET) is considered to have the highest accuracy for the assessment of myocardial perfusion in patients with suspected coronary artery disease (CAD), but its long-term prognostic accuracy in women has not been established.
Methods: A total of 619 consecutive patients (138 women, mean age 60.
Objectives: To analyse the implementation, applicability and accuracy of the pretest probability calculation provided by NICE clinical guideline 95 for decision making about imaging in patients with chest pain of recent onset.
Methods: The definitions for pretest probability calculation in the original Duke clinical score and the NICE guideline were compared. We also calculated the agreement and disagreement in pretest probability and the resulting imaging and management groups based on individual patient data from the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).
Unlabelled: Recent advances in SPECT technology including cadmium-zinc-telluride (CZT) semiconductor detector material may pave the way for absolute myocardial blood flow (MBF) measurements by SPECT. The aim of the present study was to compare K uptake rate constants as surrogates of absolute MBF and myocardial flow reserve index (MFRi) in humans as assessed with a CZT SPECT camera versus PET.
Methods: Absolute MBF was assessed in 28 consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by Tc-tetrofosmin CZT SPECT and N-ammonia PET, and MFR was calculated as a ratio of hyperemic over resting MBF.
Background: There are no prospective, prognostic data comparing cardiovascular magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) in the same population of patients with suspected coronary heart disease (CHD).
Objective: To establish the ability of CMR and SPECT to predict major adverse cardiovascular events (MACEs).
Design: Annual follow-up of the CE-MARC (Clinical Evaluation of MAgnetic Resonance imaging in Coronary heart disease) study for a minimum of 5 years for MACEs (cardiovascular death, acute coronary syndrome, unscheduled revascularization or hospital admission for cardiovascular cause).
Aims: To compare the predictive value of epicardial and intrathoracic fat volume (EFV, IFV), coronary artery calcium (CAC) score, and single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) for major adverse cardiac events (MACE).
Methods And Results: Follow-up was obtained in 275 patients with known or suspected coronary artery disease (CAD), who underwent SPECT-MPI including non-contrast cardiac computed tomography (CT) for attenuation correction to evaluate ischaemic heart disease and in whom EFV, IFV, and CAC score were calculated from non-contrast CT. Associations between fat volume, traditional cardiovascular risk factors, CAC score, and SPECT-MPI results were assessed and MACE predictors identified by Cox proportional hazard regression and global χ(2) statistics.
Aims: Left bundle branch block (LBBB) is considered an unfavourable prognostic marker in patients with underlying heart disease. Testing for coronary artery disease (CAD) is often prompted by incidental LBBB finding, but published studies disagree about a significant association between LBBB and CAD. We therefore assessed the association of LBBB with previously unknown CAD in patients undergoing coronary computed tomography angiography (CCTA).
View Article and Find Full Text PDFPurpose: The aim of this study was to evaluate the feasibility of attenuation correction (AC) for cardiac (18)F-labelled fluorodeoxyglucose (FDG) positron emission tomography (PET) using MR-based attenuation maps.
Methods: We included 23 patients with no known cardiac history undergoing whole-body FDG PET/CT imaging for oncological indications on a PET/CT scanner using time-of-flight (TOF) and subsequent whole-body PET/MR imaging on an investigational hybrid PET/MRI scanner. Data sets from PET/MRI (with and without TOF) were reconstructed using MR AC and semi-quantitative segmental (20-segment model) myocardial tracer uptake (per cent of maximum) and compared to PET/CT which was reconstructed using CT AC and served as standard of reference.
Background: Incidence of cerebral microinfarcts is higher after transcatheter aortic valve implantation (TAVI) compared with surgical aortic valve replacement (SAVR). It is unknown whether these lesions persist and what direct impact they have on health-related quality of life. The objective was to identify predictors of cerebral microinfarction and measure their effect on health-related quality of life during 6 months after TAVI when compared with SAVR.
View Article and Find Full Text PDFBackground: Echocardiographic quantification of mitral regurgitation (MR) can be challenging if the valve geometry is significantly altered. Our aim was to compare the quantification of MR by the recently developed real time three-dimensional (3D) volume color flow Doppler (RT-VCFD) method to the conventional two-dimensional (2D) echocardiographic methods during the MitraClip procedure.
Methods: Twenty-seven patients (mean age 76 ± 8 years, 56% male) were prospectively enrolled and severity of MR was assessed before and after the MitraClip procedure in the operating room by 3 different methods: (1) by integrative visual approach by transesophageal echocardiography, (2) by transthoracic 2D pulsed-wave Doppler-based calculation of aortic stroke volumes (SV) and mitral inflow allowing calculation of regurgitant volume, and (3) by transthoracic 3D RT-VCFD-based calculation of regurgitant volume.
Long term follow-up of coronary CT angiography (CCTA) is scarce. The aim of the present study was to assess the prognostic value of CCTA over a follow-up period of more than 6 years. 218 Patients were included undergoing 64-slice CCTA.
View Article and Find Full Text PDFAims: To evaluate the feasibility and image quality of coronary computed tomography angiography (CCTA) acquisition with a submillisievert fraction of effective radiation dose using model-based iterative reconstruction (MBIR) for noise reduction.
Methods And Results: In 42 patients undergoing standard low-dose (100-120 kV; 450-700 mA) and additional ultra-low-dose CCTA (80-100 kV; 150-210 mA) reconstructed with MBIR, segmental image quality was graded on a four-point scale [(i): non-evaluative, (ii): good, (iii): adequate, and (iv): excellent]. Signal-to-noise ratio (SNR) was calculated dividing left main artery (LMA) and right coronary artery (RCA) attenuation by the aortic root noise.
Objectives: It remains still unclear whether the use of modern noninvasive diagnostic modalities for evaluation of coronary artery disease (computed tomography coronary angiography (CTCA), nuclear myocardial perfusion imaging (MPI)) were able to change the "diagnostic yield" of invasive coronary angiography (ICA).
Methods: The total number of ICA in the years 2000-2009 was related to the number of percutaneous interventions (PCIs) and we assessed whether there was a significant trend over time using time series analyses. We compared these data with the number of patients undergoing CTCA and nuclear MPI in the same time period.
Background: Quantification of the mitral valve area (MVA) is important to guide percutaneous mitral valve repair using the MitraClip system. However, little is known about how to best assess MVA in this specific situation.
Methods And Results: Immediately before and after MitraClip implantation, comprehensive 3-dimensional (3D) transesophageal echocardiography data were acquired for MVA assessment by the pressure half-time method and by two 3D quantification methods (mitral valve quantification software and 3D quantification software).
Objective: ST-elevation acute myocardial infarction (STEMI) is frequently associated with reciprocal ST depression in contralateral ECG leads. The relevance of these changes is debated. This study examined whether reciprocal ECG changes in STEMI reflect larger myocardial area at risk (AAR) and/or infarct size.
View Article and Find Full Text PDFCardiac masses are usually first detected at echocardiography. In their further evaluation, cardiac magnetic resonance (MR) imaging has become a highly valuable technique. MR imaging offers incremental value owing to its larger field of view, superior tissue contrast, versatility in image planes, and unique ability to enable discrimination of different tissue characteristics, such as water and fat content, which give rise to particular signal patterns with T1- and T2-weighted techniques.
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