Diagnostic accuracy of virtual non-contrast CT for aortic valve stenosis severity evaluation.

Background: Computed tomography aortic valve calcium (AVC) score has accepted value for diagnosing and predicting outcomes in aortic stenosis (AS). Multi-energy CT (MECT) allows virtual non-contrast (VNC) reconstructions from contrast scans. We aim to compare the VNC-AVC score to the true non-contrast (TNC)-AVC score for assessing AS severity.

Individualized reduction of radiation dose with a chest circumference-adapted technique and iterative reconstructions in 256-slice retrospective and prospective ECG-triggered computed tomography coronary angiography.

Purpose: To assess the impact of chest circumference (CC)-adjusted tube current and iterative reconstructions (iDose) on individualized radiation dose reduction and image quality (IQ) in ECG-triggered computed tomography coronary angiography (CTCA).

Materials And Methods: A total of 102 patients underwent retrospectively ECG-triggered CTCA utilizing CC-adapted tube current [mAs=1000×(0.051×CC-23.

Individualized radiation dose control in 256-slice CT coronary angiography (CTCA) in retrospective ECG-triggered helical scans: using a measure of body size to adjust tube current selection.

Purpose: To reduce radiation dose for retrospective ECG-triggered helical 256-slice CTCA by determining an optimal body size index to prospectively adjust tube current.

Methods: 102 consecutive patients with suspected CAD underwent retrospective ECG-triggered CTCA using 256-slice CT scanner. Six body size indexes including BMI, nipple level (NL) bust, thoracic anteroposterior diameter at NL, chest circumference (CC) at NL, left main and right coronary artery (RCA) origin level were measured and their correlation with noise was evaluated using linear regression.

Evaluation of image quality and radiation dose at prospective ECG-triggered axial 256-slice multi-detector CT in infants with congenital heart disease.

Background: There are a limited number of reports on the technical and clinical feasibility of prospective electrocardiogram (ECG)-gated multi-detector computed tomography (MDCT) in infants with congenital heart disease (CHD).

Objective: To evaluate image quality and radiation dose at weight-based low-dose prospectively gated 256-slice MDCT angiography in infants with CHD.

Materials And Methods: From November 2009 to February 2010, 64 consecutive infants with CHD referred for pre-operative or post-operative CT were included.

Guidance of percutaneous coronary interventions by multidetector row computed tomography coronary angiography.

Guidance of percutaneous coronary interventions (PCI) by intravascular ultrasound (IVUS) provides more precise information in terms of quantitative measurement and qualitative assessment of coronary artery disease (CAD) than does conventional angiography. Several studies have tested the efficacy of IVUS to guide stent implantation. However, the conflicting results have left behind a continued debate as to whether IVUS-guided PCI has an impact on clinical outcome and angiographic restenosis.

Accuracy of low-dose prospectively gated axial coronary CT angiography for the assessment of coronary artery stenosis in patients with stable heart rate.

Background: Desirable methods for cardiac CT angiography would both reduce radiation exposure from cardiac CT angiography and preserve accuracy.

Objectives: We assessed image quality, radiation dose, and diagnostic accuracy of a low-dose, prospectively gated axial cardiac CT angiography protocol for the evaluation of patients with suspected coronary artery disease (CAD).

Methods: Fifty consecutive patients referred for diagnostic invasive coronary angiography (ICA) and with a stable heart rate < 60 beats/min after beta-blocker administration were prospectively enrolled in a single center study.

The relation between extent of coronary artery disease measured by quantitative coronary angiography and changes in lipid profile: insights from trials of atherosclerosis regression.

Background: While favorable changes in atherogenic lipids are indisputably associated with improved clinical outcomes, a similar correlation with quantitative coronary angiography (QCA) parameters is more difficult to document.

Objective: To assess the relation between changes in lipid profile and parameters of coronary artery disease (CAD) extent measured by QCA.

Methods: We evaluated 1,315 patients enrolled in trials of atherosclerosis regression and correlated their lipid profile with annualized changes in CAD score (average minimal lumen diameter for all segments evaluated), cumulative stenosis score (sum of stenoses for all segments evaluated) and average plaque area for all segments evaluated.

Influence of coronary artery stenosis severity and coronary collateralization on extent of chronic myocardial scar: insights from quantitative coronary angiography and delayed-enhancement MRI.

Objectives: In patients with chronic ischemic heart disease, the relationship between coronary artery lesion severity and myocardial scarring is unknown.The purpose of this study was to examine the relationship between proximal coronary artery stenosis severity, the amount of coronary collateralization, and myocardial scar extent in the distal distribution of the affected coronary artery based on both quantitative coronary angiography (QCA) and delayed-enhancement magnetic resonance imaging (DE-MRI).

Methods: Thirty-four patients (26 males, 8 females; age range: 35-86 years) with a coronary artery containing a single, proximal stenosis >/=30% by quantitative coronary angiography (QCA) underwent DE-MRI.

Antihypertensive therapy and regression of coronary artery disease: insights from the Comparison of Amlodipine versus Enalapril to Limit Occurrences of Thrombosis (CAMELOT) and Norvasc for Regression of Manifest Atherosclerotic Lesions by Intravascular Sonographic Evaluation (NORMALISE) trials.

Background: In patients with coronary artery disease (CAD), therapies designed to prevent clinical events are not always associated with significant reduction in coronary obstruction, as measured by quantitative coronary angiography. We set out to explore the relationship between quantitative coronary angiography parameters, baseline characteristics, and clinical events in a large trial of CAD regression with antihypertensive agents.

Methods And Results: Patients randomized to amlodipine, enalapril, or placebo in the CAMELOT trial were followed for 24 months for major ischemic events.

Relation of myocardial perfusion to mortality after primary percutaneous coronary intervention.

In patients who undergo primary percutaneous coronary intervention (PCI), poor post-PCI myocardial blush is associated with increased mortality, even when epicardial perfusion is adequate. This observation has important implications for the methods of evaluating primary PCI results and the strategies used to improve myocardial reperfusion.

Eptifibatide and low-dose tissue plasminogen activator in acute myocardial infarction: the integrilin and low-dose thrombolysis in acute myocardial infarction (INTRO AMI) trial.

Objectives: This study was designed to test the hypothesis that eptifibatide and reduced-dose tissue plasminogen activator (t-PA) will enhance infarct artery patency at 60 min in patients with acute myocardial infarction (AMI).

Background: Combination fibrin and platelet lysis improves epicardial and myocardial reperfusion in AMI.

Methods: Patients were enrolled in a dose finding (Phase A, n = 344) followed by a dose confirmation (Phase B, n = 305) protocol.