Publications by authors named "Willem B Meijboom"

Objective: To determine whether coronary computed tomography angiography (CTA) should be performed in patients with any clinical probability of coronary artery disease (CAD), and whether the diagnostic performance differs between subgroups of patients.

Design: Prospectively designed meta-analysis of individual patient data from prospective diagnostic accuracy studies.

Data Sources: Medline, Embase, and Web of Science for published studies.

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The original version of this article, published on 19 March 2018, unfortunately contained a mistake. The following correction has therefore been made in the original: The names of the authors Philipp A. Kaufmann, Ronny Ralf Buechel and Bernhard A.

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Objectives: To analyse the implementation, applicability and accuracy of the pretest probability calculation provided by NICE clinical guideline 95 for decision making about imaging in patients with chest pain of recent onset.

Methods: The definitions for pretest probability calculation in the original Duke clinical score and the NICE guideline were compared. We also calculated the agreement and disagreement in pretest probability and the resulting imaging and management groups based on individual patient data from the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).

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To estimate the probability of ≥ 50% coronary stenoses based on computed tomography (CT) segmental calcium score (SCS) and clinical factors. The Institutional Review Board approved the study. A training sample of 201 patients underwent CT calcium scoring and conventional coronary angiography (CCA).

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Aims: Non-culprit plaques are responsible for a substantial number of future events in patients with acute coronary syndrome (ACS). In this study, we evaluated the prognostic implications of non-culprit plaques seen on coronary computed tomography angiography (CTA) in patients with ACS.

Methods And Results: Coronary CTA was performed in 169 patients (mean 59 ± 11 years, 129 males) admitted with ACS.

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Objective: To investigate the value of the calcium score (CaSc) plus clinical evaluation to restrict referral for CT coronary angiography (CTCA) by reducing the number of patients with an intermediate probability of coronary artery disease (CAD).

Methods: We retrospectively included 1,975 symptomatic stable patients who underwent clinical evaluation and CaSc calculation and CTCA or invasive coronary coronary angiography (ICA). The outcome was obstructive CAD (≥50 % diameter narrowing) assessed by ICA or CTCA in the absence of ICA.

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Background: Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography.

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In the absence of a fixed relationship between plaque vulnerability and flow-limiting stenosis, alternative morphological expressions exist that could predict the liability of coronary lesions to rapidly progress or rupture, causing acute coronary syndromes. Modern multidetector computed tomography technology is capable of noninvasively detecting lesion location, attenuation, remodeling and calcification pattern, which may be considered as surrogate morphological markers of vulnerability and could contribute to increase the prognostic value of individual coronary plaque burden.

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Purpose: To investigate the effect of heart rate frequency (HRF) and heart rate variability (HRV) on radiation exposure, image quality, and diagnostic performance to help detect significant stenosis (> or =50% lumen diameter reduction) by using adaptive electrocardiographic (ECG) pulsing at dual-source (DS) spiral computed tomographic (CT) coronary angiography.

Materials And Methods: Institutional review committee approval and informed consent were obtained. No prescan beta-blockers were applied.

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We retrospectively evaluated the effect, timing and safety of different pharmacological strategies during 64-slice CT coronary angiography (CT-CA). From the institutional database of CT-CAwe enrolled 560 consecutive patients with suspected coronary artery disease. The type of drug preparation (group 1 = no treatment; group 2 = oral metoprolol; group 3 = other; group 4 = intravenous (IV) atenolol; group 5 = IV atenolol + nitrates; NR = non-responders), timing, and adverse effects were recorded.

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Purpose: To prospectively evaluate the effect of experience with coronary computed tomographic (CT) angiography on the capability to detect coronary stenoses of 50% or more.

Materials And Methods: The institutional review board approved the study protocol. All patients gave consent to undergo CT angiography before conventional coronary angiography after being informed of the additional radiation dose.

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Aims: Early atherosclerosis is located in low wall shear-stress (WSS) regions, however plaques are also found in the high WSS sensing flow divider walls of coronary bifurcations. We assessed the plaque distribution and morphology near bifurcations non-invasively with 64-slice computed tomography in relation to the WSS distribution.

Methods And Results: We inspected 65 cross-sections near coronary bifurcations for the presence of plaque.

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Aims: There is no mention in the current "appropriateness criteria for CTCA" of the need of CTCA investigation prior to an attempt at recanalisation of a CTO. To define better the role of CTCA in the treatment of patients with CTOs, we performed CTCA in a consecutive cohort of eligible patients who were scheduled for percutaneous recanalisation of a CTO.

Methods And Results: Symptomatic patients due to a CTO suitable for percutaneous treatment were included.

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Purpose: To determine the optimal width and timing of the electrocardiographic (ECG) pulsing window within the cardiac cycle in relation to heart rate (HR), image quality, and radiation exposure in patients who are suspected of having coronary artery disease.

Materials And Methods: The institutional review board approved the study, and all patients gave informed consent. Dual-source computed tomography (CT) was performed in 301 patients (mean HR, 70.

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Article Synopsis
  • * A total of 543 patients were analyzed, revealing that most had a right coronary dominance pattern, with only a small percentage showing left or balanced patterns, alongside various branching patterns in the coronary arteries.
  • * The findings showed that CT-CA is effective in visualizing complex coronary anatomy, including smaller branches, with a notable 18.4% of patients exhibiting single or multiple coronary anomalies.
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Purpose: To retrospectively compare sensitivity and specificity of four generations of multidetector computed tomographic (CT) scanners for diagnosing significant (>or=50%) coronary artery stenosis, with quantitative conventional coronary angiography as reference standard.

Materials And Methods: The institutional review board approved this study. All patients consented to undergo CT studies prior to conventional coronary angiography, after they were informed of the additional radiation dose, and to the use of their data for future retrospective research.

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Multislice Computed Tomography Coronary Angiography (CTCA) has emerged as a promising non-invasive modality for the detection of coronary artery stenosis. Image quality is still limited when compared to conventional coronary angiography. However, CTCA has been demonstrated to be highly reliable to rule out coronary artery stenosis.

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Objectives: Our objective was to prospectively evaluate the diagnostic performance of the high-speed dual-source computed tomography scanner (DSCT), with an increased temporal resolution (83 ms), for the detection of significant coronary lesions (> or =50% lumen diameter reduction) in a clinically wide range of patients.

Background: Cardiac motion artifacts may decrease coronary image quality with use of earlier computed tomography scanners that have a limited temporal resolution.

Methods: We prospectively studied 100 symptomatic patients (79 men, 21 women, mean age 61 +/- 11 years) with atypical (18%) or typical (55%) angina pectoris, or unstable coronary artery disease (27%) scheduled for conventional coronary angiography.

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Aims: To compare the performance of 64-slice computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) in the detection and classification (according to the Medina system) of bifurcation lesions (BLs).

Methods And Results: We studied 323 consecutive patients undergoing 64-slice CTCA prior to ICA. All coronary segments >or=2 mm in diameter were evaluated for the presence of a significant (>or=50% diameter reduction on quantitative coronary angiography) BL.

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Multislice CT coronary angiography (CTCA) is a rapidly emerging technique for the noninvasive visualization of coronary arteries. Over the past 5 years, several scanner generations have been introduced with a progressive improvement in the diagnostic accuracy in the detection of coronary artery stenosis in selected patient populations. The introduction of 64-slice technology, which allows high resolution and nearly motion-free coronary artery imaging, has resulted in further improvement in the diagnostic accuracy.

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Background: A high diagnostic accuracy of 64-slice CT coronary angiography (CTCA) has been reported in selected patients with stable angina pectoris, but only scant information is available in patients with non-ST elevation acute coronary syndrome (ACS).

Objectives: To study the diagnostic performance of 64-slice CTCA in patients with non-ST elevation ACS.

Patients And Methods: 64-slice CTCA was performed in 104 patients (mean (SD) age 59 (9) years) with non-ST elevation ACS.

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Objectives: We studied the diagnostic performance of 64-slice computed tomography coronary angiography (CTCA) to rule out or detect significant coronary stenosis in patients referred for valve surgery.

Background: Invasive conventional coronary angiography (CCA) is recommended in most patients scheduled for valve surgery.

Methods: During a 6-month period, 145 patients were prospectively identified from a consecutive patient population scheduled for valve surgery.

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Background: Surveillance conventional coronary angiography (CCA) is recommended 2 to 6 months after stent-supported left main coronary artery (LMCA) percutaneous coronary intervention due to the unpredictable occurrence of in-stent restenosis (ISR), with its attendant risks. Multislice computed tomography (MSCT) is a promising technique for noninvasive coronary evaluation. We evaluated the diagnostic performance of high-resolution MSCT to detect ISR after stenting of the LMCA.

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Aims: Although previous generations of multislice computed tomography (CT) have demonstrated accurate detection of obstructive bypass graft disease, progression of coronary disease is a more frequent cause for ischaemic symptoms late after bypass graft surgery. We explored the diagnostic performance of 64-slice CT in symptomatic patients after bypass surgery, for the assessment of both grafts and native coronary arteries.

Methods And Results: The 64-slice CT angiography (Siemens Sensation 64, Germany) was performed in 52 symptomatic patients, 10 +/- 5 years after bypass surgery.

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