Association of total cholesterol/ high-density lipoprotein cholesterol ratio with proximal coronary atherosclerosis detected by multislice computed tomography.

The authors assessed the association between an elevated total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio (> or = 4) and proximal coronary artery disease (CAD), as observed on multislice computed tomography. Coronary multislice computed tomographic angiography (96% on 40- or 64-slice) was performed in 295 individuals (39% women; mean age, 54 +/- 13 years) without documented CAD who were referred for coronary evaluation. Significant CAD was defined as > or = 50% stenosis in the left main, proximal left anterior descending, or > or = 2 epicardial vessels.

Prognostic utility of 64-slice computed tomography in patients with suspected but no documented coronary artery disease.

Aims: Although multislice computed tomography (MSCT) detects obstructive coronary artery disease (CAD) with high diagnostic accuracy, there is a paucity of long-term prognostic data. We sought to assess the incremental prognostic value of 64-slice CT in patients with suspected but no documented CAD.

Methods And Results: Coronary MSCT was performed on 227 individuals (61% men, mean age 54 +/- 12 years, 63% with intermediate pre-test probability) without documented CAD, referred for coronary evaluation.

Effect of dual-source cardiac computed tomography on patient radiation dose in a clinical setting: comparison to single-source imaging.

Background: Dual-source computed tomography (DSCT) was introduced with significant hardware and software changes compared with single-source CT (SSCT), resulting in improved temporal resolution (83 ms) and the potential for improved image quality. The effect of these changes on radiation dose requirements for coronary CT angiography in clinical practice has not been investigated.

Objective: We evaluated patient radiation dose and image quality of electrocardiogram (ECG)-gated helical techniques, using DSCT compared with SSCT for clinical imaging of the coronary arteries.

Association of coronary atherosclerosis detected by multislice computed tomography and traditional risk-factor assessment.

Framingham risk score is an office-based tool used for long-term coronary heart disease risk stratification. Most acute coronary events occur in association with proximal nonobstructive atherosclerotic plaque. Multislice computed tomography detects both obstructive coronary artery disease (CAD) and proximal atherosclerotic plaque with high accuracy.

The Cleveland Clinic PediPump: anatomic modeling and virtual fitting studies in a lamb model.

Implantation of ventricular assist devices (VADs) is challenging in small patients with limited space in the chest. We created three-dimensional models of lambs to facilitate fitting of the PediPump, a pediatric VAD currently under development. Serial computed tomography (CT) scans were acquired at multiple time points (n = 8) for three lambs.

Left atrial appendage filling defects identified by multidetector computed tomography in patients undergoing radiofrequency pulmonary vein antral isolation: a comparison with transesophageal echocardiography.

Background: Patients referred for radiofrequency pulmonary vein antral isolation undergo contrast-enhanced multidetector computed tomography (MDCT) to assess pulmonary vein and left atrial anatomy as well as transesophageal echocardiography (TEE) to detect intraatrial thrombus. We sought to determine the accuracy of MDCT to qualitatively and quantitatively detect severe spontaneous echo contrast (SEC) or thrombus by TEE in the left atrial appendage (LAA).

Methods: Two hundred twenty-three consecutive MDCT and TEE studies performed within 7 days of each other were retrospectively identified.

Non-invasive coronary angiography with multi-detector computed tomography: comparison to conventional X-ray angiography.

Selective coronary angiography introduced clinical coronary imaging in the late 1950s. The angiographic identification of high-grade coronary lesions in patients with acute and chronic symptomatic coronary artery disease (CAD) led to the development of surgical and percutaneous coronary revascularization. However, the fact that CAD remains the major cause of death in North America and Europe demonstrates the need for novel, complementary diagnostic strategies.

Potential clinical impact of variability in the measurement of coronary artery calcification with sequential MDCT.

Objective: The potential clinical impact of variability in the measurement of coronary artery calcification with sequential MDCT was evaluated using Agatston, volume, and mass scoring algorithms.

Subjects And Methods: Fifty-six patients were imaged twice using an identical prospectively ECG-triggered sequential scanning protocol. The Agatston, volume, and mass scores were computed by two observers independently.

Noninvasive imaging of coronary arteries: current and future role of multi-detector row CT.

While invasive imaging techniques, especially selective conventional coronary angiography, will remain vital to planning and guiding catheter-based and surgical treatment of significantly stenotic coronary lesions, the comprehensive and serial assessment of asymptomatic or minimally symptomatic stages of coronary artery disease (CAD) for preventive purposes will eventually need to rely on noninvasive imaging techniques. Cardiovascular imaging with tomographic modalities, including computed tomography (CT) and magnetic resonance imaging, has great potential for providing valuable information. This review article will describe the current and future role of cardiac CT, and in particular that of multi-detector row CT, for imaging of atherosclerotic and other pathologic changes of the coronary arteries.

Comparison of ability to identify left atrial thrombus by three-dimensional tomography versus transesophageal echocardiography in patients with atrial fibrillation.

We sought to determine the potential use of recently introduced cardiac 3-dimensional computed tomography as an alternative to transesophageal echocardiography for examination of the left atrial appendage. Our data suggest that computed tomography is a potential alternative for assessing the anatomy of the left atrial appendage and for detecting thrombi.

Non-invasive assessment of plaque morphology and remodeling in mildly stenotic coronary segments: comparison of 16-slice computed tomography and intravascular ultrasound.

Background: Non-invasive identification and characterization of mildly stenotic atherosclerotic lesions is an increasingly important focus of coronary imaging.

Design: We examined the accuracy of multi (16)-slice computed tomography (MSCT) for imaging of these lesions in comparison with intravascular ultrasound (IVUS).

Materials: Mildly stenotic segments of the left coronary artery were identified by coronary angiography and analyzed using IVUS and contrast-enhanced MSCT.

Do segmented reconstruction algorithms for cardiac multi-slice computed tomography improve image quality?

Purpose: To evaluate segmented reconstruction algorithms for spiral multi-slice computed tomography (MSCT) that use data from two cardiac cycles to improve temporal resolution (tau) for imaging of the heart.

Materials And Methods: An initial group of 78 cardiac patients (heart rates [HR] = 63-167 beats per minute [bpm]) were imaged on a 4-slice, 500 ms gantry rotation time scanner (scanner 1). Images were reconstructed with a single-segment algorithm using data from one cardiac cycle with a reconstruction window of fixed length (tau = 250 ms).