Combined stress myocardial CT perfusion and coronary CT angiography as a feasible strategy among patients presenting with acute chest pain to the emergency department.

Background: A combined approach of myocardial CT perfusion (CTP) with coronary CT angiography (CTA) was shown to have better diagnostic accuracy than coronary CTA alone. However, data on cost benefits and length of stay when compared to other perfusion imaging modalities has not been evaluated. Therefore, we aim to perform a feasibility study to assess direct costs and length of stay of a combined stress CTP/CTA and use SPECT myocardial perfusion imaging (SPECT-MPI) as a benchmark, among chest pain patients at intermediate-risk for acute coronary syndrome (ACS) presenting to the emergency department (ED).

ACR-SPR-STR Practice Parameter for the Performance of Cardiac Positron Emission Tomography - Computed Tomography (PET/CT) Imaging.

This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death.

Volumetric Single-Beat Coronary Computed Tomography Angiography: Relationship of Image Quality, Heart Rate, and Body Mass Index. Initial Patient Experience With a New Computed Tomography Scanner.

Background: Cardiac computed tomography (CT) image quality (IQ) is very important for accurate diagnosis. We propose to evaluate IQ expressed as Likert scale, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) from coronary CT angiography images acquired with a new volumetric single-beat CT scanner on consecutive patients and assess the IQ dependence on heart rate (HR) and body mass index (BMI).

Methods: We retrospectively analyzed the data of the first 439 consecutive patients (mean age, 55.

Triage of patients presenting with chest pain to the emergency department: implementation of coronary CT angiography in a large urban health care system.

Objective: There is growing evidence supporting the use of coronary CT angiography (CTA) to triage patients in the emergency department (ED) with acute chest pain and low risk of acute coronary syndrome (ACS). We hypothesized that coronary CTA can guide early management and safely discharge patients by introducing a dedicated patient management protocol.

Subjects And Methods: We conducted a prospective cohort study in three EDs of a large health care system (> 1300 beds).

Evaluation of myocardial CT perfusion in patients presenting with acute chest pain to the emergency department: comparison with SPECT-myocardial perfusion imaging.

Objective: To determine whether evaluation of resting myocardial CT perfusion (CTP) from coronary CT angiography (CTA) datasets in patients presenting with chest pain (CP) to the emergency department (ED), might have added value to coronary CTA.

Design, Setting: 76 Patients (age 54.9 y±13; 32 (42%) women) presenting with CP to the ED underwent coronary 64-slice CTA.

Cardiac CT in the emergency department: convincing evidence, but cautious implementation.

In clinical practice, assessment of chest pain patients presenting to the emergency department is difficult and the work-up can be lengthy and costly. There is growing evidence supporting the use of coronary computed tomography angiography (CTA) in early assessment of patients presenting with acute chest pain to the emergency department. CTA appears to be a faster and more accurate way to diagnosis or rule out coronary stenosis, leading to reduced hospital admissions, decreased time in the ED and lower costs.

Cardiovascular risk factors and coronary atherosclerosis in retired National Football League players.

A high prevalence of obesity exists in National Football League (NFL) players as determined by body mass index (BMI). It is not established whether increased BMI is associated with a greater prevalence of cardiovascular (CV) risk factors or coronary atherosclerosis in former NFL players than in nonathletes. This study compared CV risk factors and coronary atherosclerosis in retired NFL players to 2 groups of community controls, the population-based Dallas Heart Study and the preventive medicine cohort, the Aerobics Center Longitudinal Study.

Acute chest pain imaging in the emergency department with cardiac computed tomography angiography.

In practice, the determination of ischemic chest pain in the emergency department (ED) population is difficult and errors are common. Cardiac computed tomography angiography has recently emerged for accurate noninvasive evaluation of coronary artery disease, and it may offer a promising new approach to improve the triage of patients presenting to the ED with acute chest pain, in particular in terms of a faster and accurate way to determine the diagnosis, which could effectively reduce hospital admissions and costs. The focus of this article is to review the current literature on the use of cardiac computed tomography angiography in the ED setting by providing pooled sensitivity, specificity, and positive and negative predictive values of the published literature to date.

Measurement of Coronary Artery Calcium in Elderly Patients.

Quantification of coronary artery calcium by electron beam and spiral computed tomography (CT) is being increasingly utilized as a technique to assess the presence and extent of coronary artery disease (CAD) as well as the prognosis for clinical events in both symptomatic and asymptomatic individuals. Much of the demand for this procedure is generated by patients exposed to marketing efforts, and patients often ask physicians about the value of this test. Since elderly patients have a high prevalence of coronary artery calcium as well as a higher incidence of clinical CAD, the interpretation and clinical utility of this test differs from that for younger individuals.