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Vol 13, No 2 (2018)
Original Papers
Published online: 2018-05-30
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Diagnostic accuracy of dual-source coronary computed tomography angiography for detecting coronary artery stenosis without heart rate control comparison with invasive coronary angiography

Narumol Chaosuwannakit, Pattarapong Makarawate
DOI: 10.5603/FC.2018.0021
·
Folia Cardiologica 2018;13(2):107-113.

open access

Vol 13, No 2 (2018)
Original Papers
Published online: 2018-05-30

Abstract

Introduction. The aim of this study was to assess the diagnostic accuracy of dual-source coronary computed tomography angiography (coronary CTA) for evaluation of coronary artery disease (CAD) in daily practice without heart rate control in comparison with invasive coronary angiography (ICA). Material and methods. Forty-five consecutive patients underwent both coronary CTA and invasive coronary angiography (ICA). The mean time span between coronary CTA and ICA was 3 ± 13 days. No beta-blockers were administered prior to the scan. All coronary CTA scans were evaluated for the presence of obstructive coronary stenosis by a blinded expert, and the results were compared with ICA. Results. Coronary CTA with diagnostic image quality in 44 of the overall 45 patients. Two vessels and three segments were non diagnostic on coronary CTA. Therefore, 132 vessels and 608 segments from 45 patients were analysed. In six of seven patients with atrial fibrillation and in all 23 patients with heart rates (HR) > 65 beat per minute, image quality was diagnostic. Mean body mass index was 23.1 ± 6 kg/m2 (range 15–35 kg/m2), mean heart rate during DSCT-CA was 70.3 ± 14.2 bpm (range 47–102 bpm), and mean Agatston score was 46 ± 22 (range 0–928). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD for detect > 50% luminal narrowing were 86.4%, 96.2%, 76%, and 95.6%, respectively, by segment. Moreover, accuracy for detecting > 70% luminal narrowing was excellent by patient, vessel, and segment. The accuracy to detect patients with coronary stenoses > 50% was not significantly different among patients with HR > 65 bpm and < 65 bpm. Conclusions. Coronary CTA performed by dual-source scanner provides high diagnostic accuracy on per-segment, -vessel and -patient analyses, independent of the HR.

Abstract

Introduction. The aim of this study was to assess the diagnostic accuracy of dual-source coronary computed tomography angiography (coronary CTA) for evaluation of coronary artery disease (CAD) in daily practice without heart rate control in comparison with invasive coronary angiography (ICA). Material and methods. Forty-five consecutive patients underwent both coronary CTA and invasive coronary angiography (ICA). The mean time span between coronary CTA and ICA was 3 ± 13 days. No beta-blockers were administered prior to the scan. All coronary CTA scans were evaluated for the presence of obstructive coronary stenosis by a blinded expert, and the results were compared with ICA. Results. Coronary CTA with diagnostic image quality in 44 of the overall 45 patients. Two vessels and three segments were non diagnostic on coronary CTA. Therefore, 132 vessels and 608 segments from 45 patients were analysed. In six of seven patients with atrial fibrillation and in all 23 patients with heart rates (HR) > 65 beat per minute, image quality was diagnostic. Mean body mass index was 23.1 ± 6 kg/m2 (range 15–35 kg/m2), mean heart rate during DSCT-CA was 70.3 ± 14.2 bpm (range 47–102 bpm), and mean Agatston score was 46 ± 22 (range 0–928). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD for detect > 50% luminal narrowing were 86.4%, 96.2%, 76%, and 95.6%, respectively, by segment. Moreover, accuracy for detecting > 70% luminal narrowing was excellent by patient, vessel, and segment. The accuracy to detect patients with coronary stenoses > 50% was not significantly different among patients with HR > 65 bpm and < 65 bpm. Conclusions. Coronary CTA performed by dual-source scanner provides high diagnostic accuracy on per-segment, -vessel and -patient analyses, independent of the HR.
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Keywords

dual-source computed tomography, coronary computed tomography angiography, heart rate

About this article
Title

Diagnostic accuracy of dual-source coronary computed tomography angiography for detecting coronary artery stenosis without heart rate control comparison with invasive coronary angiography

Journal

Folia Cardiologica

Issue

Vol 13, No 2 (2018)

Pages

107-113

Published online

2018-05-30

DOI

10.5603/FC.2018.0021

Bibliographic record

Folia Cardiologica 2018;13(2):107-113.

Keywords

dual-source computed tomography
coronary computed tomography angiography
heart rate

Authors

Narumol Chaosuwannakit
Pattarapong Makarawate

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