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Iain Parsons, Chris Pavitt, Rebecca Chamley, Jo d'Arcy, Ed Nicol
INTRODUCTION: To ensure flight safety military aircrew undergo regular clinical and occupational assessment. Coronary artery calcium scoring (CACS) has been established as an imaging modality to noninvasively assess coronary artery disease (CAD). CT coronary angiography (CTCA) potentially offers a more accurate assessment of CAD, but has not been formally assessed in military aircrew. This retrospective cohort study is designed to compare the theoretical differences in downstream investigations and occupational outcomes in aircrew with suspected CAD comparing CTCA with existing CACS pathways...
February 1, 2017: Aerospace Medicine and Human Performance
Ernesto Forte, Marco Aiello, Marianna Inglese, Teresa Infante, Andrea Soricelli, Carlo Tedeschi, Marco Salvatore, Carlo Cavaliere
AIMS: Coronary artery aneurysms (CAAs) are incidentally revealed by coronary angiography and consist in a localized dilation of a coronary artery. Although invasive coronary angiography (ICA) is the gold standard imaging technique, it can lead to the underestimation of CAAs diameter in presence of parietal thrombi. Computed tomography coronary angiography (CTCA) is a very sensitive tool in CAAs detection and provides a clear visualization of coronary lumen highlighting intraluminal thrombi...
December 26, 2016: European Heart Journal Cardiovascular Imaging
Cheng Chang, Bo Ye, Wenhui Xie, Daoliang Zhang, Bei Lei, Xiaodan Ye
Silent myocardial ischemia is typically defined as objective evidence of myocardial ischemia in patients without subjective ischemia symptoms. Currently, coronary artery angiography is the gold standard for diagnosis of asymptomatic coronary artery disease (CAD). Computed tomography coronary angiography (CTCA) can visually demonstrate the morphology, trend and extent of coronary stenosis and is commonly used in clinical screening of CAD. Myocardial perfusion imaging can be used not only to identify whether anatomical stenosis causes myocardial dysfunction, but to also assess the risk stratification and prognosis of myocardial disease (MD)...
September 2016: Hellenic Journal of Nuclear Medicine
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
Gianluca Pontone, Daniele Andreini, Andrea I Guaricci, Cristina Rota, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Virginia Beltrama, Laura Fusini, Anna Solbiati, Chiara Segurini, Edoardo Conte, Paola Gripari, Andrea Annoni, Alberto Formenti, Maria Petulla', Federico Lombardi, Giuseppe Muscogiuri, Antonio L Bartorelli, Mauro Pepi
BACKGROUND: Computed tomography coronary angiography (cTCA) and stress cardiac magnetic resonance (stress-CMR) are suitable tools for diagnosing obstructive coronary artery disease in symptomatic patients with previous history of revascularization. However, performance appraisal of noninvasive tests must take in account the consequent diagnostic testing, invasive procedures, clinical outcomes, radiation exposure, and cumulative costs rather than their diagnostic accuracy only. We aimed to compare an anatomic (cTCA) versus a functional (stress-CMR) strategy in symptomatic patients with previous myocardial revascularization procedures...
October 2016: Circulation. Cardiovascular Imaging
Daniel B Adams, Om Narayan, Ravi Kiran Munnur, James D Cameron, Dennis T L Wong, Andrew H Talman, Richard W Harper, Sujith K Seneviratne, Ian T Meredith, Brian S Ko
Epidemiological studies observed a higher prevalence of coronary atherosclerosis in South Asians when compared to Caucasians, but quantitative computed tomography differences in aggregate plaque volume (APV) and epicardial fat volume (EFV) between South Asians, Southeast or East Asians (SEEAs) and Caucasians remain unknown. We aimed to compare APV and EFV quantified on computed-tomographic-coronary-angiography (CTCA) between South Asian, SEEA and Caucasian populations residing in Australia. Age, gender and body-mass-index matched subjects from three ethnic groups who underwent clinically indicated 320-detector CTCA were retrospectively analysed...
September 26, 2016: International Journal of Cardiovascular Imaging
Emily Tat, Richard Cheng, Jeffrey S Helfenstein
A 48-year-old woman with 40 years of intermittent squeezing chest pain presented with worsening symptoms. Results of an ambulatory electrocardiogram, echocardiogram, and exercise treadmill were unremarkable. Persistent symptoms prompted a computed tomography coronary angiogram (CTCA) that revealed mid-left anterior descending artery myocardial bridging (MB) that was not physiologically significant by exercise single-photon emission CT. Conservative treatment was pursued. Anatomic MB is prevalent in a large proportion of the general population and are increasingly identified by CTCA...
2016: Reviews in Cardiovascular Medicine
Patricia Carrascosa, Jonathon A Leipsic, Alejandro Deviggiano, Carlos Capunay, Javier Vallejos, Alejandro Goldsmit, Macarena C De Zan, Gaston A Rodriguez-Granillo
RATIONALE AND OBJECTIVES: We sought to explore the image quality and diagnostic performance of virtual monochromatic imaging derived from dual-energy computed tomography coronary angiography (DE-CTCA) in patients with intermediate to high likelihood of coronary artery disease (CAD) and the influence of calcification. MATERIALS AND METHODS: Consecutive symptomatic patients with suspected CAD referred for invasive coronary angiography who underwent DE-CTCA and a coronary artery calcium scoring before the invasive procedure comprised the study population...
September 9, 2016: Academic Radiology
Ravi Kiran Munnur, Nitesh Nerlekar, Dennis T L Wong
Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Atherosclerosis, which is the primary pathophysiologic mechanism for the development of plaque leading to CAD, is a multifactorial process resulting from a complex interplay between genetic susceptibility and various risk factors such as hypertension (HT), dyslipidaemia, diabetes mellitus (DM) and smoking. In addition, influences from other disease states such as chronic kidney disease (CKD), obesity and the metabolic syndrome as well as gender and ethnic diversity also contribute to the disease process...
August 2016: Cardiovascular Diagnosis and Therapy
Christian Hamilton-Craig, Jonathan Chan
Cardiac imaging is a rapidly evolving field, with improvements in the diagnostic capabilities of non-invasive cardiac assessment. We review the two main emerging technologies in cardiac imaging: computed tomography coronary angiography (CTCA) to evaluate chest symptoms and to exclude coronary artery disease; and cardiovascular magnetic resonance (CMR) for evaluating cardiac morphology, function and presence of scar. CTCA is an excellent "rule out" test, with a negative predictive value approaching 100%. Radiation exposure is no longer a concern for CTCA, with doses routinely < 5 mSv, and as low as < 1 mSv in selected patients...
August 1, 2016: Medical Journal of Australia
Francesco Maffessanti, Amit R Patel, Mita B Patel, James J Walter, Anuj Mediratta, Diego Medvedofsky, Nadjia Kachenoura, Roberto M Lang, Victor Mor-Avi
AIMS: Abnormal computed tomography coronary angiography (CTCA) often leads to stress testing to determine haemodynamic significance of stenosis. We hypothesized that instead, this could be achieved by fusion imaging of the coronary anatomy with 3D echocardiography (3DE)-derived resting myocardial deformation. METHODS AND RESULTS: We developed fusion software that creates combined 3D displays of the coronary arteries with colour maps of longitudinal strain and tested it in 28 patients with chest pain, referred for CTCA (256 Philips scanner) who underwent 3DE (Philips iE33) and regadenoson stress CT...
July 26, 2016: European Heart Journal Cardiovascular Imaging
Michael Chan, Lloyd Ridley, Douglas J Dunn, David H Tian, Kevin Liou, Jessica Ozdirik, Chaitu Cheruvu, Christopher Cao
PURPOSE: The present meta-analysis aimed to compare the diagnostic accuracy of more recent computed tomography coronary angiography (CTCA) with invasive coronary angiography (ICA) in the assessment of graft patency after coronary artery bypass graft surgery (CABG). MATERIAL AND METHODS: A systematic review was performed using nine electronic databases from their dates of inception to July 2015. Predefined inclusion criteria included studies reporting on comparative outcomes using ≥64 slice multidetector computed tomography (MDCT) and ICA...
October 15, 2016: International Journal of Cardiology
Xinbin Zhao, Yu Fu, Xiaobo Dong, Jie Yan
OBJECTIVE: To evaluate the feature and difference between treadmill exercise test (TET) and myocardial perfusion imaging (MPI) in myocardial bridge patients with symptoms.
 METHODS: The data from 97 patients, who underwent 256-slice CT coronary angiography (CTCA) on TET and MPI, were collected and analyzed retrospectively. The patients were divided into an incomplete MB group (n=41) and a complete MB group (n=56). They were also divided into three groups according to the narrow degree of mural coronary artery (MCA) during the cardiac systolic period (Nobel grade): a Nobel 1 grade group (n=44), a Nobel 2 grade group (n=42), and a Nobel 3 grade group (n=11)...
June 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Gaston A Rodriguez-Granillo, Patricia Carrascosa, Alejandro Deviggiano, Carlos Capunay, Macarena C De Zan, Alejandro Goldsmit, Roxana Campisi
AIMS: We sought to explore the relationship between pericardial fat volume (PFV) and both coronary atherosclerosis (CA) extent and severity using coronary artery calcium score (CAC), computed tomography coronary angiography (CTCA), and invasive coronary angiography in patients at high to intermediate likelihood of coronary artery disease (CAD). METHODS AND RESULTS: Patients clinically referred to invasive angiography who underwent CTCA and CAC within 1 month before the procedure comprised the study population...
July 1, 2016: European Heart Journal Cardiovascular Imaging
Michelle C Williams, Saeed Mirsadraee, Marc R Dweck, Nicholas W Weir, Alison Fletcher, Christophe Lucatelli, Tom MacGillivray, Saroj K Golay, Nicholas L Cruden, Peter A Henriksen, Neal Uren, Graham McKillop, João A C Lima, John H Reid, Edwin J R van Beek, Dilip Patel, David E Newby
OBJECTIVES: Computed tomography (CT) can perform comprehensive cardiac imaging. We compared CT coronary angiography (CTCA) and CT myocardial perfusion (CTP) with (15)O-water positron emission tomography (PET) and invasive coronary angiography (ICA) with fractional flow reserve (FFR). METHODS: 51 patients (63 (61-65) years, 80 % male) with known/suspected coronary artery disease (CAD) underwent 320-multidetector CTCA followed by "snapshot" adenosine stress CTP. Of these 22 underwent PET and 47 ICA/FFR...
June 22, 2016: European Radiology
Shuang Qiu, Shaobo Shi, Haiqin Ping, Sanfeng Zhou, Hui Wang, Bo Yang
OBJECTIVE: To quantify the efficacy of pretreatment with ivabradine compared to β-blockers before computed tomography coronary angiography (CTCA) via a meta-analysis of clinical randomized controlled trial data. METHODS: We conducted a search for randomized controlled trials of pretreatment with ivabradine compared to β-blockers before CTCA in Medline, PubMed, Embase, SCI/SSCI/A&HCI, SAS Publishers, Web of Science, and the Cochrane Central Register. The Jadad quality score of the included studies, and the mean difference (MD) in heart rate reduction, were indicators of efficacy...
June 22, 2016: Cardiology
Maria A Lewis, Ana Pascoal, Stephen F Keevil, Cornelius A Lewis
Coronary angiography to assess the presence and degree of arterial stenosis is an examination now routinely performed on CT scanners. Although developments in CT technology over recent years have made great strides in improving the diagnostic accuracy of this technique, patients with certain characteristics can still be "difficult to image". The various groups will benefit from different technological enhancements depending on the type of challenge they present. Good temporal and spatial resolution, wide longitudinal (z-axis) detector coverage and high X-ray output are the key requirements of a successful CT coronary angiography (CTCA) scan...
September 2016: British Journal of Radiology
Moon-Sun Jang, Yoshihiro Mouri, Kaoru Uchida, Shin-Ichi Aizawa, Masayuki Hayakawa, Nobuyuki Fujita, Takeaki Tezuka, Yasuo Ohnishi
UNLABELLED: Actinoplanes missouriensis, a Gram-positive and soil-inhabiting bacterium, is a member of the rare actinomycetes. The filamentous cells produce sporangia, which contain hundreds of flagellated spores that can swim rapidly for a short period of time until they find niches for germination. These swimming cells are called zoospores, and the mechanism of this unique temporal flagellation has not been elucidated. Here, we report all of the flagellar genes in the bacterial genome and their expected function and contribution for flagellar morphogenesis...
August 15, 2016: Journal of Bacteriology
S P Harden, R K Bull, R W Bury, E A Castellano, B Clayton, M C K Hamilton, G J Morgan-Hughes, D O'Regan, S P G Padley, G H Roditi, C A Roobottom, J Stirrup, E D Nicol
Computed tomography coronary angiography is increasingly used in imaging departments in the investigation of patients with chest pain and suspected coronary artery disease. Due to the routine use of heart rate controlling medication and the potential for very high radiation doses during these scans, there is a need for guidance on best practice for departments performing this examination, so the patient can be assured of a good quality scan and outcome in a safe environment. This article is a summary of the document on 'Standards of practice of computed tomography coronary angiography (CTCA) in adult patients' published by the Royal College of Radiologists (RCR) in December 2014...
August 2016: Clinical Radiology
Robert F Hamburger, John A Spertus, David E Winchester
BACKGROUND: Because the Diamond-Forrester (DF) model is predictive of obstructive coronary artery disease (CAD), it is often used to risk stratify acute chest pain patients. We sought to further evaluate the clinical utility of the DF model within a chest pain evaluation center. METHODS: Consecutive patients with chest pain and no known CAD or evidence of active ischemia were asked to participate in a prospective registry. Patients were classified based on cardiovascular risk factors, age, and DF classification...
June 2016: Critical Pathways in Cardiology
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