Advertisement






Click here for more guidelines.
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2007; 50:2393-2398, doi:10.1016/j.jacc.2007.09.017 (Published online 11 December 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2007.09.017v1
50/25/2393    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (31)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ropers, U.
Right arrow Articles by Achenbach, S.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Ropers, U.
Right arrow Articles by Achenbach, S.

CLINICAL RESEARCH: CARDIAC IMAGING

Influence of Heart Rate on the Diagnostic Accuracy of Dual-Source Computed Tomography Coronary Angiography

Ulrike Ropers, MD*, Dieter Ropers, MD*, Tobias Pflederer, MD*, Katharina Anders, MD{dagger}, Axel Kuettner, MD{dagger}, Nikolaos I. Stilianakis, MD§,||, Sei Komatsu, MD*, Willi Kalender, MD{ddagger}, Werner Bautz, MD{dagger}, Werner G. Daniel, MD, FACC* and Stephan Achenbach, MD, FACC*,*

* Department of Internal Medicine 2 (Cardiology–Angiology), University of Erlangen-Nuremberg, Erlangen, Germany
{dagger} Institute of Diagnostic Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
{ddagger} Institute of Medical Physics, University of Erlangen-Nuremberg, Erlangen, Germany
§ Department of Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
|| Joint Research Centre, European Commission, Ispra (Va), Italy.

Manuscript received June 18, 2007; revised manuscript received August 16, 2007, accepted September 10, 2007.

* Reprint requests and correspondence: Dr. Stephan Achenbach, Department of Cardiology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany. (Email: stephan.achenbach{at}uk-erlangen.de).

Objectives: We evaluated the influence of heart rate on image quality and diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography.

Background: Multidetector computed tomography (MDCT) coronary angiography has demonstrated an inverse relationship between heart rate and image quality. Dual-source CT provides a higher temporal resolution.

Methods: One hundred patients were studied by DSCT (DEFINITION, Siemens Medical Solutions, Forchheim, Germany). A contrast-enhanced volume dataset was acquired (two tubes, 120 kV, 400 mAs/rot, collimation 64 x 0.6 mm). Datasets were evaluated concerning the presence of significant coronary stenoses and validated against invasive coronary angiography.

Results: In 44 patients with a heart rate ≥65 beats/min, 566 of 616 coronary segments were evaluable (92%), whereas in 56 patients with a heart rate <65 beats/min, 777 of 778 coronary segments were evaluable (100%, p < 0.001). On a per-patient basis, 93% of patients (≥65 beats/min) and 100% of patients (<65 beats/min) were considered evaluable. By classifying unevaluable segments as positive for stenosis, per-patient sensitivity was 95% (19 of 20) for heart rates ≥65 beats/min and 100% (22 of 22) for heart rates <65 beats/min. Specificity was 87% (21 of 24) versus 76% (26 of 34), and overall diagnostic accuracy was 91% (40 of 44) versus 86% (48 of 56). None of these differences were statistically significant. Similarly, no difference in diagnostic accuracy was found in per-vessel and -segment analyses.

Conclusions: In 100 patients studied without beta-blocker pre-medication, DSCT demonstrated slightly lower per-segment evaluability for high heart rates but no decrease in diagnostic accuracy for the detection of coronary artery stenoses.

Abbreviations and Acronyms
  CT = computed tomography
  DSCT = dual-source computed tomography
  ECG = electrocardiogram
  MDCT = multidetector computed tomography




This article has been cited by other articles:


Home page
RadiologyHome page
G. Bastarrika, Y. S. Lee, W. Huda, B. Ruzsics, P. Costello, and U. J. Schoepf
CT of Coronary Artery Disease
Radiology, November 1, 2009; 253(2): 317 - 338.
[Abstract] [Full Text] [PDF]


Home page
RadiologyHome page
S. Baumuller, S. Leschka, L. Desbiolles, P. Stolzmann, H. Scheffel, B. Seifert, B. Marincek, and H. Alkadhi
Dual-Source versus 64-Section CT Coronary Angiography at Lower Heart Rates: Comparison of Accuracy and Radiation Dose
Radiology, October 1, 2009; 253(1): 56 - 64.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
A. Wiant, E. Nyberg, and R. C. Gilkeson
CT Evaluation of Congenital Heart Disease in Adults
Am. J. Roentgenol., August 1, 2009; 193(2): 388 - 396.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
G. Bastarrika, C. Thilo, G. F. Headden, P. L. Zwerner, P. Costello, and U. J. Schoepf
Cardiac CT in the Assessment of Acute Chest Pain in the Emergency Department
Am. J. Roentgenol., August 1, 2009; 193(2): 397 - 409.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc ImagingHome page
N. Bettencourt, J. Rocha, M. Carvalho, D. Leite, A. M. Toschke, B. Melica, L. Santos, A. Rodrigues, M. Goncalves, P. Braga, et al.
Multislice Computed Tomography in the Exclusion of Coronary Artery Disease in Patients With Presurgical Valve Disease
Circ Cardiovasc Imaging, July 1, 2009; 2(4): 306 - 313.
[Abstract] [Full Text] [PDF]


Home page
Circ Cardiovasc ImagingHome page
U. Hoffmann and F. Bamberg
Is Computed Tomography Coronary Angiography the Most Accurate and Effective Noninvasive Imaging Tool to Evaluate Patients With Acute Chest Pain in the Emergency Department?: CT Coronary Angiography Is the Most Accurate and Effective Noninvasive Imaging Tool for Evaluating Patients Presenting With Chest Pain to the Emergency Department
Circ Cardiovasc Imaging, May 1, 2009; 2(3): 251 - 263.
[Full Text] [PDF]


Home page
Circ Cardiovasc ImagingHome page
R. C. Hendel
Is Computed Tomography Coronary Angiography the Most Accurate and Effective Noninvasive Imaging Tool to Evaluate Patients With Acute Chest Pain in the Emergency Department?: CT Coronary Angiography Is the Most Accurate and Effective Noninvasive Imaging Tool for Evaluating Patients Presenting With Chest Pain to the Emergency Department: Antagonist Viewpoint
Circ Cardiovasc Imaging, May 1, 2009; 2(3): 264 - 275.
[Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
R. Donnino, J. E. Jacobs, J. V. Doshi, E. M. Hecht, D. C. Kim, J. S. Babb, and M. B. Srichai
Dual-Source Versus Single-Source Cardiac CT Angiography: Comparison of Diagnostic Image Quality
Am. J. Roentgenol., April 1, 2009; 192(4): 1051 - 1056.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
B. Sundaram, S. Patel, N. Bogot, and E. A. Kazerooni
Anatomy and Terminology for the Interpretation and Reporting of Cardiac MDCT: Part 1, Structured Report, Coronary Calcium Screening, and Coronary Artery Anatomy
Am. J. Roentgenol., March 1, 2009; 192(3): 574 - 583.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
H. Scheffel, S. Baumueller, P. Stolzmann, S. Leschka, A. Plass, H. Alkadhi, and T. Schertler
Atrial Myxomas and Thrombi: Comparison of Imaging Features on CT
Am. J. Roentgenol., March 1, 2009; 192(3): 639 - 645.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
R. J. Gibbons, P. A. Araoz, and E. E. Williamson
The year in cardiac imaging.
J. Am. Coll. Cardiol., January 6, 2009; 53(1): 54 - 70.
[Full Text] [PDF]


Home page
ESC Textbook of Cardiovascular MedicineHome page
P. J. de Feyter, S. Achenbach, and K. Nieman
CHAPTER 6 Cardiovascular Computed Tomography
ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract] [Full Text] [PDF]


Home page
Asian Cardiovasc. Thorac. Ann.Home page
H. Doi, R. Koshima, M. Suzuki, K. Takahashi, H. Yokoyama, and N. Yoshida
Can 64-Row Computed Tomography Replace Angiography After Coronary Bypass?
Asian Cardiovasc Thorac Ann, December 1, 2008; 16(6): 444 - 449.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
P. Stolzmann, H. Scheffel, S. Leschka, A. Plass, S. Baumuller, B. Marincek, and H. Alkadhi
Influence of Calcifications on Diagnostic Accuracy of Coronary CT Angiography Using Prospective ECG Triggering
Am. J. Roentgenol., December 1, 2008; 191(6): 1684 - 1689.
[Abstract] [Full Text] [PDF]


Home page
RadiologyHome page
P. Stolzmann, T. Frauenfelder, T. Pfammatter, N. Peter, H. Scheffel, M. Lachat, B. Schmidt, B. Marincek, H. Alkadhi, and T. Schertler
Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair: Detection with Dual-Energy Dual-Source CT
Radiology, November 1, 2008; 249(2): 682 - 691.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
H Scheffel, H Alkadhi, S Leschka, A Plass, L Desbiolles, I Guber, T Krauss, J Gruenenfelder, M Genoni, T F Luescher, et al.
Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance
Heart, September 1, 2008; 94(9): 1132 - 1137.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
D. A. Bluemke, S. Achenbach, M. Budoff, T. C. Gerber, B. Gersh, L. D. Hillis, W. G. Hundley, W. J. Manning, B. F. Printz, M. Stuber, et al.
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young
Circulation, July 29, 2008; 118(5): 586 - 606.
[Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement