Chest CT for triage during COVID-19 on the emergency department: myth or truth?

Purpose: We aimed to investigate the diagnostic performance of chest CT compared with first RT-PCR results in adult patients suspected of COVID-19 infection in an ED setting. We also constructed a predictive machine learning model based on chest CT and additional data to improve the diagnostic accuracy of chest CT.

Methods: This study's cohort consisted of 319 patients who underwent chest CT and RT-PCR testing at the ED.

Superior Risk Stratification With Coronary Computed Tomography Angiography Using a Comprehensive Atherosclerotic Risk Score.

Objectives: This study was designed to assess the prognostic value of a new comprehensive coronary computed tomography angiography (CTA) score compared with the stenosis severity component of the Coronary Artery Disease-Reporting and Data System (CAD-RADS).

Background: Current risk assessment with coronary CTA is mainly focused on maximal stenosis severity. Integration of plaque extent, location, and composition in a comprehensive model may improve risk stratification.

Non-invasive computed tomography coronary angiography as a gatekeeper for invasive coronary angiography.

To determine the rate of subsequent invasive coronary angiography (ICA) and revascularization in relation to computed tomography coronary angiography (CTA) results. In addition, independent determinants of subsequent ICA and revascularization were evaluated. CTA studies were performed using a 64-row (n = 413) or 320-row (n = 224) multidetector scanner.

Prognostic value of coronary vessel dominance in relation to significant coronary artery disease determined with non-invasive computed tomography coronary angiography.

Aims: Limited information is available regarding the relationship between coronary vessel dominance and prognosis. Therefore, the purpose of this study was to determine the prognostic value of coronary vessel dominance in relation to significant coronary artery disease (CAD) in patients referred for computed tomography coronary angiography (CTA).

Methods And Results: The study population consisted of 1425 patients (869 men, 57 ± 12 years) referred for CTA.

Age- and gender-specific differences in the prognostic value of CT coronary angiography.

Objective: To evaluate the potential age- and gender-specific differences in the incidence and prognostic value of coronary artery disease (CAD) in patients undergoing CT coronary angiography (CTA).

Design And Patients: In this multicentre prospective registry study, 2432 patients (mean age 57 ± 12, 56% male) underwent CTA for suspected CAD. Patients were stratified into four groups according to age <60 or ≥60 years and, male or female gender.

Prognostic value of renal dysfunction for the prediction of outcome versus results of computed tomographic coronary angiography.

Chronic kidney disease (CKD) is associated with cardiovascular (CV) events caused by advanced atherosclerosis. Computed tomographic coronary angiography (CTA) can accurately diagnose coronary artery disease (CAD) and predict CV outcomes. The aim of the present study was to evaluate whether moderate CKD provides prognostic information for CV events in patients undergoing CTA.

Feasibility of diastolic function assessment with cardiac CT: feasibility study in comparison with tissue Doppler imaging.

Objectives: This study aimed to demonstrate the feasibility of multidetector row computed tomography (CT) for assessment of diastolic function in comparison with 2-dimensional (2D) echocardiography using tissue Doppler imaging (TDI).

Background: Diastolic left ventricular (LV) function plays an important role in patients with cardiovascular disease. 2D echocardiography using TDI has been used most commonly to evaluate diastolic LV function.

Influence of smoking on the prognostic value of cardiovascular computed tomography coronary angiography.

Aims: Computed tomography coronary angiography (CTA) is an important non-invasive imaging modality increasingly used for the diagnosis and prognosis of coronary artery disease (CAD). The purpose of the current study was to determine the influence of smoking status on the prognostic value of CTA in patients with suspected or known CAD.

Methods And Results: In 1207 patients (57% male, age 57 ± 12 years) referred for CTA, the presence of significant CAD (≥ 50% stenosis) was determined.

Impact of clinical presentation and pretest likelihood on the relation between calcium score and computed tomographic coronary angiography.

The purpose of the present study was to assess the impact of clinical presentation and pretest likelihood on the relation between coronary calcium score (CCS) and computed tomographic coronary angiography (CTA) to determine the role of CCS as a gatekeeper to CTA in patients presenting with chest pain. In 576 patients with suspected coronary artery disease (CAD), CCS and CTA were performed. CCS was categorized as 0, 1 to 400, and >400.

Relationship between obstructive coronary artery disease and abnormal stress testing in patients with paroxysmal or persistent atrial fibrillation.

Atrial fibrillation (AF) has been linked to the presence of underlying coronary artery disease (CAD). However, whether the higher burden of CAD observed in AF patients translates into higher burden of myocardial ischemia is unknown. In 87 patients (71% male, mean age 61 ± 10 years) with paroxysmal or persistent AF and without history of CAD, MSCT coronary angiography and stress testing (exercise ECG test or myocardial perfusion imaging) were performed.

Incremental prognostic value of left ventricular function analysis over non-invasive coronary angiography with multidetector computed tomography.

Background: The purpose of this study was to determine the prognostic value of computed tomography coronary angiography (CTA)-derived left ventricular (LV) function analysis and to assess its incremental prognostic value over the detection of significant stenosis using CTA.

Methods: In 728 patients (400 males, mean age 55 ± 12 years) with known or suspected CAD, the presence of significant stenosis (≥ 50% stenosis) and LV function were assessed using CTA. LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), and LV ejection fraction (LVEF) were calculated.

Predictive value of multislice computed tomography variables of atherosclerosis for ischemia on stress-rest single-photon emission computed tomography.

Background: previous studies have shown that the presence of stenosis alone on multislice computed tomography (MSCT) has a limited positive predictive value for the presence of ischemia on myocardial perfusion imaging (MPI). The purpose of this study was to assess which variables of atherosclerosis on MSCT angiography are related to ischemia on MPI.

Methods And Results: both MSCT and MPI were performed in 514 patients.

Automated quantification of stenosis severity on 64-slice CT: a comparison with quantitative coronary angiography.

Objectives: This study sought to demonstrate the feasibility of a dedicated algorithm for automated quantification of stenosis severity on multislice computed tomography in comparison with quantitative coronary angiography (QCA).

Background: Limited information is available on quantification of coronary stenosis, and previous attempts using semiautomated approaches have been suboptimal.

Methods: In patients who had undergone 64-slice computed tomography and invasive coronary angiography, the most severe lesion on QCA was quantified per coronary artery using quantitative coronary computed tomography (QCCTA) software.

Diabetes: prognostic value of CT coronary angiography--comparison with a nondiabetic population.

Purpose: To evaluate the prognostic value of multidetector computed tomographic (CT) coronary angiography in a diabetic population known to have or suspected of having coronary artery disease (CAD) compared with that in nondiabetic individuals.

Materials And Methods: Institutional review board approval and patient informed consent were obtained. Three hundred thirteen patients with type 2 diabetes mellitus (DM) and 303 patients without DM underwent unenhanced 64-detector row CT, at which a calcium score was obtained, followed by CT angiography.

Coronary artery calcium scoring in cardiovascular risk assessment.

Identification of patients at risk of future coronary artery disease (CAD) events traditionally relies on scoring tools that take demographic and clinical characteristics into account (e.g., the Framingham risk score in the United States and the Heart Score in Europe).

Function and anatomy: SPECT-MPI and MSCT coronary angiography.

For the diagnosis of coronary artery disease (CAD), non-invasive cardiac imaging is indispensable. Myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) investigates the pathophysiological consequences of luminal obstructive CAD, while multislice computed tomography coronary angiography (CTA) indicates the presence, extent and location of coronary atherosclerosis. The integration of CTA and SPECT data may provide important information which may be useful for patient management.

Reduced left ventricular torsion early after myocardial infarction is related to left ventricular remodeling.

Background: Left ventricular (LV) torsion is emerging as a sensitive parameter of LV systolic myocardial performance. The aim of the present study was to explore the effects of acute myocardial infarction (AMI) on LV torsion and to determine the value of LV torsion early after AMI in predicting LV remodeling at 6-month follow-up.

Methods And Results: A total of 120 patients with a first ST-segment elevation AMI (mean+/-SD age, 59+/-10 years; 73% male) were included.

Assessment with multi-slice computed tomography and gray-scale and virtual histology intravascular ultrasound of gender-specific differences in extent and composition of coronary atherosclerotic plaques in relation to age.

Data evaluating gender- and age-specific differences in plaque observations on multislice computed tomography (MSCT) are scarce. Accordingly, the aim of this study was to evaluate coronary plaque patterns in men and women in relation to age using MSCT. The findings were compared to observations on grayscale intravascular ultrasound (IVUS) and virtual histology (VH) IVUS.

Impact of left ventricular dyssynchrony early on left ventricular function after first acute myocardial infarction.

The impact of left ventricular (LV) dyssynchrony after acute myocardial infarction (AMI) on LV ejection fraction (EF) is unknown. One hundred twenty-nine patients with a first ST-elevation AMI (58 + or - 11 years, 78% men) and QRS duration <120 ms were included. All patients underwent primary percutaneous coronary intervention.

Diagnostic accuracy of 64-slice multislice computed tomographic coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease.

Data on the diagnostic accuracy of multislice computed tomographic coronary angiography (CTA) have been mostly derived from patients with a high pretest likelihood of coronary artery disease. Systematic comparisons with invasive angiography in patients with an intermediate pretest likelihood are scarce. The purpose of the present study was to determine the diagnostic accuracy of CTA in patients without known coronary artery disease with an intermediate pretest likelihood.

Incremental value of subclinical left ventricular systolic dysfunction for the identification of patients with obstructive coronary artery disease.

Background: Left ventricular (LV) diastolic dysfunction and subclinical systolic dysfunction may be markers of coronary artery disease (CAD). However, whether these markers are useful for prediction of obstructive CAD is unknown.

Methods: A total of 182 consecutive outpatients (54 +/- 10 years, 59% males) without known CAD and overt LV systolic dysfunction underwent 64-slice multislice computed tomography (MSCT) coronary angiography and echocardiography.

Combined non-invasive anatomical and functional assessment with MSCT and MRI for the detection of significant coronary artery disease in patients with an intermediate pre-test likelihood.

Objectives: To compare magnetic resonance myocardial perfusion imaging (MRI) with anatomical assessment by multislice computed tomography (MSCT) coronary angiography and conventional coronary angiography.

Design And Patients: In this prospective study, 53 patients (60% male, average age 57+/-9 years, 83% intermediate pre-test likelihood) underwent 1.5 T MRI, 64-slice MSCT and conventional coronary angiography.

Prevalence of coronary artery disease assessed by multislice computed tomography coronary angiography in patients with paroxysmal or persistent atrial fibrillation.

Background: Although atrial fibrillation (AF) has been linked to underlying coronary artery disease (CAD), data supporting this association have been based on ECG and clinical history for the definition of CAD rather than direct visualization of atherosclerosis.

Methods And Results: The prevalence of CAD among patients with paroxysmal or persistent AF and without history of CAD was evaluated using multislice computed tomography. Multislice computed tomography was performed in 150 patients with AF (61+/-11 years, 67% males, 58% asymptomatic) with predominantly low (59%) or intermediate (25%) pretest likelihood of CAD.

The value of multi-slice-computed tomography coronary angiography for risk stratification.

Multi-slice-computed tomography coronary angiography (CTA) provides direct non-invasive anatomic assessment of the coronary arteries allowing for early identification of coronary artery disease (CAD). This information is useful for diagnosis of CAD, particularly the rule out of CAD. In addition, early identification of CAD with CTA may also be useful for risk stratification.

Relation between Framingham risk categories and the presence of functionally relevant coronary lesions as determined on multislice computed tomography and stress testing.

Noninvasive assessment of subclinical atherosclerosis by multislice computed tomographic (MSCT) coronary angiography and demonstration of significant, flow-limiting coronary artery disease (CAD) by stress testing may improve patients' risk stratification. However, data relating the complementary information provided by these noninvasive techniques to traditional risk assessment are scarce. In 255 subjects (45% women, mean age 54 +/- 12 years) without known CAD, 64-slice MSCT coronary angiography and stress testing (exercise electrocardiographic test or myocardial perfusion imaging) were performed.