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The Role of Cardiac Computed Tomography in Heart Failure. Curr Heart Fail Rep 2022; 19:213-222. [PMID: 35588344 DOI: 10.1007/s11897-022-00553-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Cardiac computed tomography (CT) is becoming a more widely applied tool in the diagnosis and management of a variety of cardiovascular conditions, including heart failure. The aim of this narrative review is to examine the role of cardiac CT in patients with heart failure. RECENT FINDINGS Coronary computed tomographic angiography has robust diagnostic accuracy for ruling out coronary artery disease. These data are reflected in updated guidelines from major cardiology organizations. New roles for cardiac CT in myocardial imaging, perfusion scanning, and periprocedural planning, execution, and monitoring are being implemented. Cardiac CT is useful in ruling out coronary artery disease its diagnostic accuracy, accessibility, and safety. It is also intricately linked to invasive cardiac procedures that patients with heart failure routinely undergo.
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Melero-Ferrer JL, López-Vilella R, Morillas-Climent H, Sanz-Sánchez J, Sánchez-Lázaro IJ, Almenar-Bonet L, Martínez-Dolz L. Novel Imaging Techniques for Heart Failure. Card Fail Rev 2016; 2:27-34. [PMID: 28875038 DOI: 10.15420/cfr.2015:29:2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Imaging techniques play a main role in heart failure (HF) diagnosis, assessment of aetiology and treatment guidance. Echocardiography is the method of choice for its availability, cost and it provides most of the information required for the management and follow up of HF patients. Other non-invasive cardiac imaging modalities, such as cardiovascular magnetic resonance (CMR), nuclear imaging-positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and computed tomography (CT) could provide additional aetiological, prognostic and therapeutic information, especially in selected populations. This article reviews current indications and possible future applications of imaging modalities to improve the management of HF patients.
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Affiliation(s)
- Josep L Melero-Ferrer
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Raquel López-Vilella
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Herminio Morillas-Climent
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Jorge Sanz-Sánchez
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Ignacio J Sánchez-Lázaro
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Luis Almenar-Bonet
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
| | - Luis Martínez-Dolz
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Department, Hospital Universitari i Politècnic La Fe,Valencia, Spain
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Sousa PA, Bettencourt N, Dias Ferreira N, Carvalho M, Leite D, Ferreira W, de Jesus I, Gama V. Role of cardiac multidetector computed tomography in the exclusion of ischemic etiology in heart failure patients. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Sousa PA, Bettencourt N, Dias Ferreira N, Carvalho M, Leite D, Ferreira W, de Jesus I, Gama V. Role of cardiac multidetector computed tomography in the exclusion of ischemic etiology in heart failure patients. Rev Port Cardiol 2014; 33:629-36. [DOI: 10.1016/j.repc.2014.02.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/11/2014] [Indexed: 11/29/2022] Open
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de Araujo Goncalves P, Campos CAM, Serruys PW, Garcia-Garcia HM. Computed tomography angiography for the interventional cardiologist. Eur Heart J Cardiovasc Imaging 2014; 15:842-54. [DOI: 10.1093/ehjci/jeu053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Walther S, Schueler S, Tackmann R, Schuetz GM, Schlattmann P, Dewey M. Compliance with STARD Checklist among Studies of Coronary CT Angiography: Systematic Review. Radiology 2014; 271:74-86. [DOI: 10.1148/radiol.13121720] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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ten Kate GJR, Caliskan K, Dedic A, Meijboom WB, Neefjes LA, Manintveld OC, Krenning BJ, Ouhlous M, Nieman K, Krestin GP, de Feyter PJ. Computed tomography coronary imaging as a gatekeeper for invasive coronary angiography in patients with newly diagnosed heart failure of unknown aetiology. Eur J Heart Fail 2014; 15:1028-34. [DOI: 10.1093/eurjhf/hft090] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gert-Jan R. ten Kate
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Kadir Caliskan
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
| | - Admir Dedic
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - W. Bob Meijboom
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
| | - Lisan A. Neefjes
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | | | | | - Mohammed Ouhlous
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Koen Nieman
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Gabriel P. Krestin
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Pim J. de Feyter
- Department of Cardiology; Thorax Centre Rotterdam; The Netherlands
- Department of Radiology; Erasmus Medical Centre; Rotterdam The Netherlands
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Moe GW, Ezekowitz JA, O'Meara E, Howlett JG, Fremes SE, Al-Hesayen A, Heckman GA, Ducharme A, Estrella-Holder E, Grzeslo A, Harkness K, Lepage S, McDonald M, McKelvie RS, Nigam A, Rajda M, Rao V, Swiggum E, Virani S, Van Le V, Zieroth S, Arnold JMO, Ashton T, D'Astous M, Dorian P, Giannetti N, Haddad H, Isaac DL, Kouz S, Leblanc MH, Liu P, Ross HJ, Sussex B, White M. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization. Can J Cardiol 2013; 30:249-63. [PMID: 24480445 DOI: 10.1016/j.cjca.2013.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 10/09/2013] [Accepted: 10/09/2013] [Indexed: 12/25/2022] Open
Abstract
The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.
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Affiliation(s)
- Gordon W Moe
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
| | | | - Eileen O'Meara
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | | | - Steve E Fremes
- Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | - Abdul Al-Hesayen
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Anique Ducharme
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | | | - Adam Grzeslo
- Joseph Brant Memorial Hospital, Burlington, Ontario, Canada; Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Harkness
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Serge Lepage
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michael McDonald
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Robert S McKelvie
- Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Anil Nigam
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
| | - Miroslaw Rajda
- QE II Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vivek Rao
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Sean Virani
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Vy Van Le
- Centre Hospitalier Universitaire de l'Université de Montréal, Québec, Canada
| | - Shelley Zieroth
- Cardiac Sciences Program, St Boniface General Hospital, Winnipeg, Manitoba, Canada
| | | | | | | | - Paul Dorian
- St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Simon Kouz
- Centre Hospitalier Régional de Lanaudière, Joliette, and Université Laval, Québec, Canada
| | | | - Peter Liu
- Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Heather J Ross
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Sussex
- Health Sciences Centre, St John's, Newfoundland, Canada
| | - Michel White
- Institut de Cardiologie de Montréal, Montreal, Québec, Canada
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Patel MR, White RD, Abbara S, Bluemke DA, Herfkens RJ, Picard M, Shaw LJ, Silver M, Stillman AE, Udelson J. 2013 ACCF/ACR/ASE/ASNC/SCCT/SCMR appropriate utilization of cardiovascular imaging in heart failure: a joint report of the American College of Radiology Appropriateness Criteria Committee and the American College of Cardiology Foundation Appropriate Use Criteria Task Force. J Am Coll Cardiol 2013; 61:2207-31. [PMID: 23500216 DOI: 10.1016/j.jacc.2013.02.005] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Methodological quality of diagnostic accuracy studies on non-invasive coronary CT angiography: influence of QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) items on sensitivity and specificity. Eur Radiol 2013; 23:1603-22. [PMID: 23322410 DOI: 10.1007/s00330-012-2763-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 11/29/2012] [Accepted: 12/10/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the methodological quality of diagnostic accuracy studies on coronary computed tomography (CT) angiography using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies included in systematic reviews) tool. METHODS Each QUADAS item was individually defined to adapt it to the special requirements of studies on coronary CT angiography. Two independent investigators analysed 118 studies using 12 QUADAS items. Meta-regression and pooled analyses were performed to identify possible effects of methodological quality items on estimates of diagnostic accuracy. RESULTS The overall methodological quality of coronary CT studies was merely moderate. They fulfilled a median of 7.5 out of 12 items. Only 9 of the 118 studies fulfilled more than 75 % of possible QUADAS items. One QUADAS item ("Uninterpretable Results") showed a significant influence (P = 0.02) on estimates of diagnostic accuracy with "no fulfilment" increasing specificity from 86 to 90 %. Furthermore, pooled analysis revealed that each QUADAS item that is not fulfilled has the potential to change estimates of diagnostic accuracy. CONCLUSIONS The methodological quality of studies investigating the diagnostic accuracy of non-invasive coronary CT is only moderate and was found to affect the sensitivity and specificity. An improvement is highly desirable because good methodology is crucial for adequately assessing imaging technologies. KEY POINTS • Good methodological quality is a basic requirement in diagnostic accuracy studies. • Most coronary CT angiography studies have only been of moderate design quality. • Weak methodological quality will affect the sensitivity and specificity. • No improvement in methodological quality was observed over time. • Authors should consider the QUADAS checklist when undertaking accuracy studies.
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Schuetz GM, Schlattmann P, Dewey M. Use of 3x2 tables with an intention to diagnose approach to assess clinical performance of diagnostic tests: meta-analytical evaluation of coronary CT angiography studies. BMJ 2012; 345:e6717. [PMID: 23097549 PMCID: PMC3480336 DOI: 10.1136/bmj.e6717] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine whether a 3 × 2 table, using an intention to diagnose approach, is better than the "classic" 2 × 2 table at handling transparent reporting and non-evaluable results, when assessing the accuracy of a diagnostic test. DESIGN Based on a systematic search for diagnostic accuracy studies of coronary computed tomography (CT) angiography, full texts of relevant studies were evaluated to determine whether they could calculate an alternative 3 × 2 table. To quantify an overall effect, we pooled diagnostic accuracy values according to a meta-analytical approach. DATA SOURCES Medline (via PubMed), Embase (via Ovid), and ISI Web of Science electronic databases. ELIGIBILITY CRITERIA Prospective English or German language studies comparing coronary CT with conventional coronary angiography in all patients and providing sufficient data for a patient level analysis. RESULTS 120 studies (10,287 patients) were eligible. Studies varied greatly in their approaches to handling non-evaluable findings. We found 26 studies (including 2298 patients) that allowed us to calculate both 2 × 2 tables and 3 × 2 tables. Using a bivariate random effects model, we compared the 2 × 2 table with the 3 × 2 table, and found significant differences for pooled sensitivity (98.2 (95% confidence interval 96.7 to 99.1) v 92.7 (88.5 to 95.3)), area under the curve (0.99 (0.98 to 1.00) v 0.93 (0.91 to 0.95)), positive likelihood ratio (9.1 (6.2 to 13.3) v 4.4 (3.3 to 6.0)), and negative likelihood ratio (0.02 (0.01 to 0.04) v 0.09 (0.06 to 0.15); (P<0.05)). CONCLUSION Parameters for diagnostic performance significantly decrease if non-evaluable results are included by a 3 × 2 table for analysis (intention to diagnose approach). This approach provides a more realistic picture of the clinical potential of diagnostic tests.
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Affiliation(s)
- Georg M Schuetz
- Department of Radiology, The Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Freie Universität Berlin, 10117 Berlin, Germany
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Ananthasubramaniam K, Dhar R, Cavalcante JL. Role of multimodality imaging in ischemic and non-ischemic cardiomyopathy. Heart Fail Rev 2011; 16:351-67. [PMID: 21165696 DOI: 10.1007/s10741-010-9218-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Chronic heart failure (CHF) is a major and growing problem in the western hemisphere, affecting about 5 million patients in the United States. In daily practice patients with left ventricular systolic dysfunction (LVSD) and significant angiographic coronary artery disease (CAD) are felt to have an ischemic cardiomyopathy (ICMP) and those without CAD or mild-moderate CAD out of proportion to the extent of LVSD are felt to have a non-ischemic cardiomyopathy (NICMP). Although invasive coronary angiography is the gold standard for the diagnosis of CAD, recent advances in non-invasive imaging have created multiple options for evaluating ICMP and NICMP. This review details the role of cardiac imaging in the diagnosis of ICMP and NICMP and outlines an algorithm of use of non-invasive tests in asymtomatic LVSD and symptomatic heart failure.
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Affiliation(s)
- Karthikeyan Ananthasubramaniam
- Heart & Vascular Institute, Department of Internal Medicine, Henry Ford Hospital, 2799 West Grand Blvd, K-14, Detroit, MI 48202, USA.
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Influence of coronary artery disease prevalence on predictive values of coronary CT angiography: a meta-regression analysis. Eur Radiol 2011; 21:1904-13. [PMID: 21597986 DOI: 10.1007/s00330-011-2142-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/09/2011] [Accepted: 03/11/2011] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To evaluate the impact of coronary artery disease (CAD) prevalence on the predictive values of coronary CT angiography. METHODS We performed a meta-regression based on a generalised linear mixed model using the binomial distribution and a logit link to analyse the influence of the prevalence of CAD in published studies on the per-patient negative and positive predictive values of CT in comparison to conventional coronary angiography as the reference standard. A prevalence range in which the negative predictive value was higher than 90%, while at the same time the positive predictive value was higher than 70% was considered appropriate. RESULTS The summary negative and positive predictive values of coronary CT angiography were 93.7% (95% confidence interval [CI] 92.8-94.5%) and 87.5% (95% CI, 86.5-88.5%), respectively. With 95% confidence, negative and positive predictive values higher than 90% and 70% were available with CT for a CAD prevalence of 18-63%. CT systems with >16 detector rows met these requirements for the positive (P < 0.01) and negative (P < 0.05) predictive values in a significantly broader range than systems with ≤16 detector rows. CONCLUSION It is reasonable to perform coronary CT angiography as a rule-out test in patients with a low-to-intermediate likelihood of disease.
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Bhatti S, Hakeem A, Yousuf MA, Al-Khalidi HR, Mazur W, Shizukuda Y. Diagnostic performance of computed tomography angiography for differentiating ischemic vs nonischemic cardiomyopathy. J Nucl Cardiol 2011; 18:407-20. [PMID: 21328027 DOI: 10.1007/s12350-011-9346-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 01/23/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Although the use of computed tomography angiography (CTA) is considered "appropriate" to distinguish ischemic vs nonischemic etiology in patients with cardiomyopathy under the current clinical practice guideline, the evidence to support this has not been evaluated in larger scale studies. Thus, we conducted a meta-analysis of available studies published by October 2010 to address this question. METHODS Studies evaluating the diagnostic accuracy of CTA versus invasive coronary angiography (as the gold standard) for significant coronary artery disease (CAD) detection (ischemic cardiomyopathy) in patients with no known history of CAD with significantly depressed left ventricular function (ejection fraction; EF < 35%) were selected for the meta-analysis. Sensitivity, specificity, positive, and negative likelihood ratios were calculated on per patient and per segment basis using random effects model (DerSimonian-Laird Method) for computing summary estimates and receiver operator curve (ROC) analysis for evaluating overall diagnostic accuracy. RESULTS Six studies comprising 452 patients met the selection criteria for the meta-analysis. The pooled patient population was 62 ± 3 years old, with 29% females, 16% diabetics, and 43% with a history of hypertension. Mean EF was 32% ± 1%. The pooled summary estimate of sensitivity of CTA for diagnosis of ischemic cardiomyopathy was 98% [95% confidence interval (CI); 94% to 99%] and specificity was 97% (CI 94% to 98%), yielding a negative likelihood ratio of 0.06 (CI 0.02 to 0.13) and positive likelihood ratio of 20.85 (CI 12 to 36). There was no significant heterogeneity between studies for these estimates. The receiver operator curve analysis showed a robust discriminate diagnostic accuracy of ischemic etiology with an area under curve of 0.99 (P < .00001). CONCLUSION CTA appears as a clinically applicable accurate diagnostic modality to exclude ischemic etiology in patients with cardiomyopathy of undetermined cause and this further supports the appropriateness of the use of CTA to determine the cause of new onset cardiomyopathy of unknown etiology.
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Affiliation(s)
- Sabha Bhatti
- Division of Cardiovascular Diseases, Department of Internal Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.
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Boulmier D, Audinet C, Heautot JF, Larralde A, Veillard D, Hamonic S, Bedossa M, Leurent G, Garreau M, Le Breton H. Clinical contributions of 64-slice computed tomography in the evaluation of cardiomyopathy of unknown origin. Arch Cardiovasc Dis 2009; 102:685-96. [DOI: 10.1016/j.acvd.2009.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 06/16/2009] [Accepted: 06/26/2009] [Indexed: 11/16/2022]
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Pernès JM, Sirol M, Chabbert V, Christiaens L, Alison D, Hamon M, Caussin C. Les indications actuelles du scanner cardiaque. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2009. [DOI: 10.1016/s1878-6480(09)70351-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Informative value of clinical research on multislice computed tomography in the diagnosis of coronary artery disease: A systematic review. Int J Cardiol 2008; 130:386-404. [DOI: 10.1016/j.ijcard.2008.06.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 05/21/2008] [Accepted: 06/28/2008] [Indexed: 11/22/2022]
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Sheikine Y, Di Carli MF. Integrated PET/CT in the assessment of etiology and viability in ischemic heart failure. Curr Heart Fail Rep 2008; 5:136-42. [DOI: 10.1007/s11897-008-0022-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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le Polain de Waroux JB, Pouleur AC, Goffinet C, Pasquet A, Vanoverschelde JL, Gerber BL. Combined coronary and late-enhanced multidetector-computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast-enhanced cardiac magnetic resonance imaging. Eur Heart J 2008; 29:2544-51. [PMID: 18762553 PMCID: PMC2567022 DOI: 10.1093/eurheartj/ehn381] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Aims To evaluate whether comprehensive evaluation of coronary anatomy and delayed enhancement (DE) by multidetector-computed tomography (MDCT) would allow determination of etiology of left ventricular dysfunction (LVD) as compared with coronary angiography (CA) and DE-magnetic resonance (CMR). Methods and results Seventy-one consecutive patients (50 males, 59 ± 16 years) with LVD (ejection fraction: 26 ± 11%) of unknown etiology underwent MDCT, LGE (late Gd-DTPA-enhanced)-CMR and CA. Patients were classified into four groups according to coronary artery disease (CAD) by CA and LGE-CMR patterns. Patients (n = 24) with CAD and transmural or sub-endocardial DE by CMR were considered having definite ischaemic LVD (group 1). Patients (n = 36) without CAD by CA and with no/atypical LGE-CMR were considered non-ischaemic LVD (group 2). Further we identified four patients with transmural DE but no CAD (group 3) and seven patients with CAD but no DE (group 4). On per-patient basis, combined coronary and DE-MDCT had excellent agreement (κ = 0.89; P < 0.001) with CA/LGE-CMR to classify patients into the same four groups. Sensitivity, specificity and accuracy of MDCT were 97, 92 and 94%, respectively for detecting patients with definite (group 1) or likely (groups 3 and 4) ischaemic LVD. Conclusion Combined coronary and DE-MDCT can accurately differentiate ischaemic vs. non-ischaemic etiology of LVD.
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Ghostine S, Caussin C, Habis M, Habib Y, Clément C, Sigal-Cinqualbre A, Angel CY, Lancelin B, Capderou A, Paul JF. Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography. Eur Heart J 2008; 29:2133-40. [PMID: 18385120 DOI: 10.1093/eurheartj/ehn072] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIMS We evaluated the accuracy of 64-slice computed tomography (CT) to identify ischaemic aetiology of heart failure (IHF). METHODS AND RESULTS Ninety-three consecutive patients in sinus rhythm with dilated cardiomyopathy but without suspicion of coronary artery disease (CAD) were enrolled when admitted for angiography. Accuracy of CT to detect significant stenosis (>50% lumen narrowing) was compared with quantitative coronary angiography. IHF was defined as a significant stenosis on left main or proximal left anterior descending artery or two or more vessels. Forty-three out of 1395 segments (3%) were heavily calcified and excluded. CT correctly assessed 103 of 142 (73%) significant stenosis and identified 46 of 50 (92%) patients without and 42 of 43 (98%) patients with CAD, 60 of 62 (97%) patients without and 28 of 31 (90%) patients with IHF. Overall, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT for identifying CAD by segment was 96, 73, 99, 92, and 97%, respectively; by patient was 95, 98, 92, 91, and 98%, respectively; and for identifying IHF was 95, 90, 97, 93, and 95%, respectively. CONCLUSION Non-invasive 64-slice CT assessment of the extent of CAD may offer a valid alternative to angiography for the diagnosis of IHF.
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Affiliation(s)
- Saïd Ghostine
- Department of Cardiology, Marie Lannelongue Hospital, 133 avenue de la Resistance, 92350 Le Plessis Robinson, France.
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Manghat NE, Morgan-Hughes GJ, Shaw SR, Broadley AJ, Gogola L, Marshall AJ, Roobottom CA. Multi-detector row CT coronary angiography in patients with cardiomyopathy -- initial single-centre experience. Clin Radiol 2007; 62:632-8. [PMID: 17556031 DOI: 10.1016/j.crad.2007.01.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Revised: 01/03/2007] [Accepted: 01/08/2007] [Indexed: 10/23/2022]
Abstract
AIMS To evaluate the diagnostic accuracy of computed tomography (CT) in assessing haemodynamically significant coronary artery stenoses in patients with cardiomyopathy (CM). SUBJECTS AND METHODS Eighteen patients with CM were approached to undergo CT coronary angiography to evaluate the use of this technique for investigating the presence of significant coronary artery disease (CAD), and also to compare the findings with catheter angiography. RESULTS On a segment-by-segment analysis the sensitivity, specificity, positive and negative predictive values in the CM group were 66.7, 96.5, 40 and 98.8%, respectively, with 100% accuracy in "whole-patient terms". CONCLUSION Non-invasive, 16-detector row CT coronary angiography in patients with presumed CM would seem to be a useful clinical tool for the exclusion of significant coronary artery disease. However, the presence of suboptimal contrast opacification in this patient group means that the implication of these results must be interpreted with caution.
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Affiliation(s)
- N E Manghat
- Departments of Clinical Radiology, Derriford Hospital, Plymouth, Devon PL6 8DH, UK.
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