Prognostic value of stress-gated 99m-technetium SPECT myocardial perfusion imaging: risk stratification of patients with multivessel coronary artery disease and prior coronary revascularization.

Background: This study assessed the prognostic value of stress-gated 99mTc-sestamibi myocardial perfusion SPECT (MPS) in patients with multivessel coronary artery disease (CAD) and prior revascularization according to the presence and severity of ischemia.

Methods And Results: We studied the outcome of 472 patients with multivessel CAD and prior revascularization (coronary angioplasty, 290 patients; bypass surgery, 182 patients), who underwent exercise or dipyridamole 99mTc-sestamibi MPS for evaluation of ischemia. Visual scoring of perfusion images used 20 segments and a 5-point scale.

Accuracy of dual-source CT to identify significant coronary artery disease in patients with uncontrolled hypertension presenting with chest pain: comparison with coronary angiography.

It has been previously reported that the sensitivity and specificity of multislice CT for detecting significant CAD (coronary artery disease) is high. Chest pain is a common presentation in patients with uncontrolled hypertension. We investigated the sensitivity and specificity of dual-source CT to detect and rule out significant CAD in patients presenting with uncontrolled hypertension accompanied by chest pain.

Coronary vessel and luminal area measurement using dual-source computed tomography in comparison with intravascular ultrasound: effect of window settings on measurement accuracy.

Background: Image display settings (window and level) have a substantial impact on measurements of coronary artery and plaque dimensions in computed tomography (CT), and their influence on measurement accuracy has not been systematically evaluated. We analyzed the influence of window width/level settings on the accuracy for determining cross-sectional lumen and outer vessel diameters in contrast-enhanced CT angiography compared with intravascular ultrasound (IVUS).

Methods: We evaluated the data sets of 35 patients.

Automated three-dimensional quantification of noncalcified coronary plaque from coronary CT angiography: comparison with intravascular US.

Purpose: To determine the accuracy of a previously developed automated algorithm (AUTOPLAQ [APQ]) for rapid volumetric quantification of noncalcified and calcified plaque from coronary computed tomographic (CT) angiography in comparison with intravascular ultrasonography (US).

Materials And Methods: This study was approved by the institutional review board and was HIPAA compliant; all patients provided written informed consent. APQ combines derived scan-specific attenuation threshold levels for lumen, plaque, and knowledge-based segmentation of coronary arteries for quantification of plaque components.

Accuracy of dual-source computed tomography to identify significant coronary artery disease in patients with atrial fibrillation: comparison with coronary angiography.

Aims: It has been previously reported that the sensitivity and specificity of multislice computed tomography (CT) for detecting significant coronary artery disease (CAD) is high. However, regular sinus rhythm has been considered a prerequisite for an adequate examination, even though atrial fibrillation (AF) is common among patients evaluated for the presence of coronary heart disease. In this study, we investigated the sensitivity and specificity of dual-source CT (DSCT) to detect and rule out significant coronary stenoses in patients with AF referred for invasive coronary angiography.

Characterization of culprit lesions in acute coronary syndromes using coronary dual-source CT angiography.

Objective: We analyzed typical morphological features of coronary atherosclerotic plaques in acute coronary syndromes (ACS) using contrast-enhanced coronary Dual-Source CT angiography (CTA) in comparison to stable coronary lesions.

Patients And Methods: Fifty-five patients with ACS and 55 controls with stable angina pectoris (SAP) with similar atherosclerotic risk profile were studied. CT angiography was performed using a Dual-Source CT scanner (330 ms rotation, 2 x 64 x 0.

Prevalence of first-pass myocardial perfusion defects detected by contrast-enhanced dual-source CT in patients with non-ST segment elevation acute coronary syndromes.

Objective: To investigate the prevalence and diagnostic value of first-pass myocardial perfusion defects (PD) visualised by contrast-enhanced multidetector computed tomography (MDCT) in patients admitted for a first acute coronary syndrome (ACS).

Methods: Thirty-eight patients with non-ST segment elevation myocardial infarction (NSTEMI) or unstable angina (UA) and scheduled for percutaneous coronary intervention underwent dual-source CT immediately before catheterisation. CT images were analysed for the presence of any PD by using a 17-segment model.

Quantification of non-calcified coronary atherosclerotic plaques with dual-source computed tomography: comparison with intravascular ultrasound.

Background: The quantification of non-calcified coronary plaques using multidetector computed tomography has not been extensively investigated.

Objective: To evaluate the ability of dual-source computed tomography (DSCT) to quantify non-calcified plaque volumes using intravascular ultrasound (IVUS) as the standard of reference.

Methods: The datasets of 70 patients with suspected or known coronary artery disease who underwent DSCT (330 ms gantry rotation, 2 x 64 x 0.

Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition.

Aims: We evaluated the feasibility and image quality of a new scan mode for coronary computed tomography angiography (CTA) with an effective dose of less than 1 mSv.

Methods And Results: In 50 consecutive patients (body weight View Article and Find Full Text PDF

Comparison of dual source computed tomography versus intravascular ultrasound for evaluation of coronary arteries at least one year after cardiac transplantation.

This study evaluated the ability of dual-source computed tomography (DSCT) to detect coronary allograft vasculopathy (CAV) in heart transplant recipients using intravascular ultrasound (IVUS) as the standard of reference. Thirty patients with heart transplants (81% men, mean age 40 years) underwent DSCT (330-ms gantry rotation, 2 x 64 x 0.6-mm collimation, 60- to 80-ml contrast agent, no additional beta blockers) before invasive coronary angiography including IVUS of 1 vessel.

Radiation exposure and image quality in staged low-dose protocols for coronary dual-source CT angiography: a randomized comparison.

Objective: To evaluate staged low-dose approaches for coronary CT angiography (CTA) in which a standard sequence was added if the low-dose sequence did not allow reliable rule-out of coronary stenosis.

Patients And Methods: A total of 176 consecutive patients referred for dual-source CTA were randomized to three protocols: group 1 using prospective ECG-triggering (100 kV, 330 mAs), group 2 a retrospectively gated "MinDose" sequence (100 kV, 330 mAs) and group 3 a standard spiral sequence (120 kV, 400 mAs). If image quality in low-dose groups 1 or 2 was non-diagnostic, an additional standard CT examination (as in group 3) was performed.

Prospectively ECG-triggered high-pitch spiral acquisition for coronary CT angiography using dual source CT: technique and initial experience.

Objective: We evaluated radiation exposure and image quality of a new coronary CT angiography protocol, high-pitch spiral acquisition, using dual source CT (DSCT).

Material And Methods: Coronary CTAwas performed in 25 consecutive patients with a stable heart rate of 60 bpm or less after premedication, using 2 x 128 0.6-mm sections, 38.

Left bundle branch block causes relative but not absolute septal underperfusion during exercise.

Aims: Left bundle branch block (LBBB) often causes septal perfusion defects in radionuclide myocardial perfusion imaging using exercise (Ex) but rarely using vasodilator stress. We studied whether this is due to an underlying structural disease inherent to spontaneous LBBB or whether it is also found in temporary LBBB induced by right ventricular pacing (PM) indicating a functional rather than a structural alteration.

Methods And Results: Regional myocardial blood flow (MBF) at rest and at Ex was measured with 15O-H2O and PET in 10 age-matched healthy volunteers (controls), 10 LBBB patients and 10 PM patients with right ventricular pacing off and on (PM off and PM on).

Coronary CT angiography and myocardial perfusion imaging to detect flow-limiting stenoses: a potential gatekeeper for coronary revascularization?

Aims: To evaluate the diagnostic accuracy of a combined non-invasive assessment of coronary artery disease with coronary CT angiography (CTA) and myocardial perfusion imaging (MPI) for the detection of flow-limiting coronary stenoses and its potential as a gatekeeper for invasive examination and treatment.

Methods And Results: In 78 patients (mean age 65 +/- 9 years) referred for coronary angiography (CA), additional CTA and MPI (using single-photon emission-computed tomography) were performed and the findings not communicated. Detection of flow-limiting stenoses (justifying revascularization) by the combination of CTA and MPI (CTA/MPI) was compared with the combination of quantitative coronary angiography (QCA) plus MPI (QCA/MPI), which served as standard of reference.

Caffeine impairs myocardial blood flow response to physical exercise in patients with coronary artery disease as well as in age-matched controls.

Background: Caffeine is one of the most widely consumed pharmacologically active substances. Its acute effect on myocardial blood flow is widely unknown. Our aim was to assess the acute effect of caffeine in a dose corresponding to two cups of coffee on myocardial blood flow (MBF) in coronary artery disease (CAD).

High-pitch spiral acquisition: a new scan mode for coronary CT angiography.

Coronary CT angiography allows high-quality imaging of the coronary arteries when state-of-the-art CT systems are used. However, radiation exposure has been a concern. We describe a new scan mode that uses a very high-pitch spiral acquisition, "Flash Spiral," which has been developed specifically for low-dose imaging with dual-source CT.

Multimodality preoperative planning and postoperative follow-up of a hybrid cardiac intervention.

We describe the case of a 59-year-old man who had aortic regurgitation and a hypoplastic aortic valve and for whom an echocardiography evaluation revealed a vascular tumor in the roof of the left atrium, which was suspected to be a hemangioma. After undergoing preoperative invasive catheter coronary angiography, echocardiography, and multislice computed tomography examinations, the patient underwent an aortic miniroot replacement. Intraoperative findings confirmed the findings of the preoperative evaluations.

Role of attenuation correction to discriminate defects caused by left bundle branch block versus coronary stenosis in single photon emission computed tomography myocardial perfusion imaging.

Purpose: To define the impact of attenuation correction (AC) on interpretation of perfusion abnormalities induced by left bundle branch block (LBBB) in myocardial perfusion imaging (MPI) and single photon emission computed tomography (SPECT).

Methods: Thirty-six patients with spontaneous and 12 with pacemaker (PM)-induced LBBB (mean age 68.6 +/- 9.

Protocol for measuring myocardial blood flow by PET/CT in cats.

Purpose: The aim of this study was to establish a protocol for measuring myocardial blood flow (MBF) by PET/CT in healthy cats. The rationale was its future use in Maine Coon cats with hypertrophic cardiomyopathy (HCM) as a model for human HCM.

Methods: MBF was measured in nine anaesthetized healthy cats using a PET/CT scanner and (13)NH(3) at rest and during adenosine infusion.

Accuracy of quantitative coronary angiography with computed tomography and its dependency on plaque composition: plaque composition and accuracy of cardiac CT.

Objective: To determine the impact of plaque composition on accuracy of quantitative 64-slice computed tomography coronary angiography (CTCA).

Methods: The institutional review board approved this study; written informed consent was obtained from all patients. One hundred consecutive patients (42 women, mean age 64.

Functionally relevant coronary artery disease: comparison of 64-section CT angiography with myocardial perfusion SPECT.

Purpose: To prospectively determine the accuracy of 64-section computed tomographic (CT) angiography for the depiction of coronary artery disease (CAD) that induces perfusion defects at myocardial perfusion imaging with single photon emission computed tomography (SPECT), by using myocardial perfusion imaging as the reference standard.

Materials And Methods: All patients gave written informed consent after the study details, including radiation exposure, were explained. The study protocol was approved by the local institutional review board.

Impact of hypertension on the diagnostic accuracy of coronary angiography with computed tomography.

Objective: Hypertension induces coronary artery disease (CAD) and progression of arterial wall calcification. As coronary calcifications may cause artefacts in 64-slice computed tomography coronary angiography (CTCA), we sought to determine the diagnostic accuracy of CTCA in patients with and without arterial hypertension.

Methods: Eighty-five consecutive patients with suspected CAD underwent CTCA, calcium-scoring and conventional coronary angiography, and were grouped as hypertensive (28 women, 31 men, mean age 65 +/- 9 years, age range 49-82 years) or normotensive patients (10 women, 16 men, mean age 62 +/- 11 years, age range 39-77 years).

Comparison of diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low, intermediate, and high cardiovascular risk.

Rationale And Objectives: The aim of this study was to compare the diagnostic accuracy of 64-slice computed tomographic coronary angiography (CTCA) in groups of patients with low, intermediate, and high risk for coronary artery disease (CAD) events.

Materials And Methods: The institutional review board approved this study; written informed consent was obtained from all patients. Eighty-eight consecutive patients with suspected CAD (40 women; mean age, 64.

Coronary 64-slice CT angiography predicts outcome in patients with known or suspected coronary artery disease.

The aim of this study was to assess the prognostic value of 64-slice CT angiography (CTA) in patients with known or suspected coronary artery disease (CAD). Sixty-four-slice coronary CTA was performed in 220 patients [mean age 63 +/- 11 years, 77 (35%) female] with known or suspected CAD. CTA images were analyzed with regard to the presence and number of coronary lesions.

Myocardial bridging: depiction rate and morphology at CT coronary angiography--comparison with conventional coronary angiography.

Purpose: To prospectively assess the depiction rate and morphologic features of myocardial bridging (MB) of coronary arteries with 64-section computed tomographic (CT) coronary angiography in comparison to conventional coronary angiography.

Materials And Methods: Patients were simultaneously enrolled in a prospective study comparing CT and conventional coronary angiography, for which ethics committee approval and informed consent were obtained. One hundred patients (38 women, 62 men; mean age, 63.