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https://www.readbyqxmd.com/read/29138258/challenges-in-delivering-computed-tomography-coronary-angiography-as-the-first-line-test-for-stable-chest-pain
#1
John G Dreisbach, Edward D Nicol, Carl A Roobottom, Simon Padley, Giles Roditi
OBJECTIVE: The National Institute for Health and Care Excellence (NICE) clinical guidelines 'chest pain of recent onset: assessment and diagnosis' (update 2016) state CT coronary angiography (CTCA) should be offered as the first-line investigation for patients with stable chest pain. However, the current provision in the UK is unknown. We aimed to evaluate this and estimate the requirements for full implementation of the guidelines including geographical variation. Ancillary aims included surveying the number of CTCA-capable scanners and accredited practitioners in the UK...
November 14, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29080955/fusion-of-ct-coronary-angiography-and-whole-heart-dynamic-3d-cardiac-mr-perfusion-building-a-framework-for-comprehensive-cardiac-imaging
#2
Jochen von Spiczak, Robert Manka, Alexander Gotschy, Sabrina Oebel, Sebastian Kozerke, Sandra Hamada, Hatem Alkadhi
The purpose of this work was to develop a framework for 3D fusion of CT coronary angiography (CTCA) and whole-heart dynamic 3D cardiac magnetic resonance perfusion (3D-CMR-Perf) image data-correlating coronary artery stenoses to stress-induced myocardial perfusion deficits for the assessment of coronary artery disease (CAD). Twenty-three patients who underwent CTCA and 3D-CMR-Perf for various indications were included retrospectively. For CTCA, image quality and coronary diameter stenoses > 50% were documented...
October 28, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29072898/the-epstein-barr-virus-b-zip-protein-zta-recognizes-specific-dna-sequences-containing-5-methylcytosine-and-5-hydroxymethylcytosine
#3
Desiree Tillo, Sreejana Ray, Khund-Sayeed Syed, Mary Rose Gaylor, Ximiao He, Jun Wang, Nima Assad, Stewart R Durell, Aleksey Porollo, Matthew T Weirauch, Charles Vinson
The Epstein-Barr virus (EBV) B-ZIP transcription factor Zta binds to many DNA sequences containing methylated CG dinucleotides. Using protein binding microarrays (PBMs), we analyzed the sequence specific DNA binding of Zta to four kinds of double-stranded DNA (dsDNA): (1) DNA containing cytosine in both strands, (2) DNA with 5-methylcytosine (5mC) in one strand and cytosine in the second strand, (3) DNA with 5-hydroxymethylcytosine (5hmC) in one strand and cytosine in the second strand, and (4) DNA in which both cytosines in all CG dinucleotides contain 5mC...
November 10, 2017: Biochemistry
https://www.readbyqxmd.com/read/29060821/stenosis-detection-and-quantification-on-cardiac-ctca-using-panoramic-mip-of-coronary-arteries
#4
Y Chi, W Huang, J Zhou, K K Toe, J-M Zhang, P Wong, S T Lim, R S Tan, L Zhong
In this work, we proposed to demonstrate the entire 3D coronary tree using panoramic maximum intensity projection (MIP) of coronary arteries, and to detect and quantify coronary stenosis from computed tomography coronary angiography (CTCA). The performance of the proposed method was assessed in comparison with invasive coronary angiography (ICA) as reference standard. Six anonymized CTCA datasets were tested. MIP method achieved a sensitivity of 82% and a specificity of 95% for the stenosis detection with a good reproducibility (i...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059819/smartool-a-tool-for-clinical-decision-support-for-the-management-of-patients-with-coronary-artery-disease-based-on-modeling-of-atherosclerotic-plaque-process
#5
Antonis I Sakellarios, George Rigas, Vassiliki Kigka, Panagiotis Siogkas, Panagiota Tsompou, Georgia Karanasiou, Themis Exarchos, Ioannis Andrikos, Nikolaos Tachos, Gualtriero Pelosi, Oberdan Parodi, Dimitrios I Fotiaids
SMARTool aims to the development of a clinical decision support system (CDSS) for the management and stratification of patients with coronary artery disease (CAD). This will be achieved by performing computational modeling of the main processes of atherosclerotic plaque growth. More specifically, computed tomography coronary angiography (CTCA) is acquired and 3-dimensional (3D) reconstruction is performed for the arterial trees. Then, blood flow and plaque growth modeling is employed simulating the major processes of atherosclerosis, such as the estimation of endothelial shear stress (ESS), the lipids transportation, low density lipoprotein (LDL) oxidation, macrophages migration and plaque development...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29052025/ultra-low-dose-ct-coronary-angiography-using-128-slice-dual-source-ct-with-low-concentration-contrast-agent-initial-experience
#6
Lei Zhao, Aishi Liu, Youmin Guo
PURPOSE: To optimize and evaluate an ultra-low-dose (ULD) technique for CT coronary angiography (CTCA). MATERIALS AND METHODS: Eighty-two patients were randomly divided into two groups. ULD and routine CTCA were performed in groups A and B. Image quality, radiation dose and contrast agent were evaluated. RESULTS: The effective dose (ED) was 0.20 ± 0.01 mSv for the ULD technique, a decrease of 87% (t = - 21.182, P < 0.001) compared with the control group...
October 19, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29051477/low-kv-and-low-concentration-contrast-agent-with-iterative-reconstruction-of-computed-tomography-ct-coronary-angiography-a-preliminary-study
#7
Hong Zhang, Yanhe Ma, Jun Lyu, Yapeng Yang, Wei Yuan, Zhenchun Song
BACKGROUND The aim of this study was to evaluate the image quality and radiation dose of CT coronary angiography (CTCA) with low kV, low concentration contrast agent, and iterative reconstruction. MATERIAL AND METHODS Ninety cases were randomly divided into 3 groups according to contrast agent concentration: group A 270 mg/ml (100 kV), group B 350 mg/ml (120 kV), and group C 370 mg/ml (120 kV), with 30 cases per group. Tube current was 200-250 mAs. Collimator width was 128×0.6 mm. Rotation speed was 0.27 s...
October 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28871240/in-vivo-and-in-vitro-analysis-in-coronary-artery-disease-related-to-type-2-diabetes
#8
Teresa Infante, Ernesto Forte, Marco Aiello, Marco Salvatore, Carlo Cavaliere
AIM: The leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (DM) is coronary artery disease (CAD), a condition often asymptomatic but severe in these patients. Although glucose metabolism impairment and oxidative stress are known actors in the endothelial dysfunction/remodeling that occurs in diabetic patients, the relationship between cardiovascular disorders and DM is not fully understood. We have performed both an in vivo imaging and in vitro molecular analysis to investigate diabetic-specific CAD alterations...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28844992/diagnostic-and-prognostic-benefits-of-computed-tomography-coronary-angiography-using-the-2016-national-institute-for-health-and-care-excellence-guidance-within-a-randomised-trial
#9
Philip D Adamson, Amanda Hunter, Michelle C Williams, Anoop Sv Shah, David A McAllister, Tania A Pawade, Marc R Dweck, Nicholas L Mills, Colin Berry, Nicholas A Boon, Elizabeth Clark, Marcus Flather, John Forbes, Scott McLean, Giles Roditi, Edwin Jr van Beek, Adam D Timmis, David E Newby
OBJECTIVES: To evaluate the diagnostic and prognostic benefits of CT coronary angiography (CTCA) using the 2016 National Institute for Health and Care Excellence (NICE) guidelines for the assessment of suspected stable angina. METHODS: Post hoc analysis of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial of 4146 participants with suspected angina randomised to CTCA. Patients were dichotomised into NICE guideline-defined possible angina and non-anginal presentations...
August 27, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28822985/evaluation-of-coronary-artery-disease-as-a-risk-factor-for-reticular-pseudodrusen
#10
Rachel V McCarter, Gareth J McKay, Nicola B Quinn, Usha Chakravarthy, Tom J MacGillivray, Gavin Robertson, Enrico Pellegrini, Emanuele Trucco, Michelle C Williams, Tunde Peto, Baljean Dhillon, Edwin Jr van Beek, David E Newby, Frank Kee, Ian S Young, Ruth E Hogg
PURPOSE: Reticular pseudodrusen (RPD) are a risk factor for late age-related macular degeneration (AMD). Associations between RPD and coronary artery disease (CAD) have been reported from small case-control studies. This study investigated the association of RPD within a predominantly CAD cohort. METHODS: A subgroup of subjects from a multicentre randomised controlled trial of CT coronary angiography (CTCA) underwent ultrawide field (UWF) retinal imaging CAD determined by CTCA and was categorised as normal, non-obstructive or obstructive...
August 19, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28797768/ct-coronary-angiography-findings-in-non-atherosclerotic-coronary-artery-diseases
#11
REVIEW
Z Zhou, L Xu, N Zhang, H Wang, W Liu, Z Sun, Z Fan
Non-atherosclerotic coronary artery diseases are being increasingly recognised as causes of acute coronary events. Invasive coronary angiography frequently fails to identify the abnormalities in the proximal course of coronary arteries and coronary wall, while computed tomography coronary angiography (CTCA) allows for acquisition of more detailed information. CTCA serves as a reliable method for evaluating patients with non-atherosclerotic coronary artery diseases. The purpose of this article is to provide an overview of non-atherosclerotic abnormalities that may be demonstrated on CTCA...
August 7, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28765182/a-vulnerable-plaque-identified-on-ct-coronary-angiography-when-should-we-act-in-stable-coronary-artery-disease
#12
Sarah R Blake, Thomas D Heseltine, Scott Murray, Balazs Ruzsics
CT coronary angiography (CTCA) is increasingly being used to diagnose coronary artery disease (CAD). Recent technological advancements, including dual energy CT and improved gantry times, have led to the ability to image coronary arteries with excellent spatial resolution at low radiation doses. Atheromatous plaques can be identified using CTCA and assessed to establish the risk of acute coronary syndrome from each individual plaque. If CTCA identifies CAD, it should then be used in conjunction with functional testing or invasive angiography with physiological assessment to establish the significance of coronary disease in an individual patient...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28728443/functional-assessment-of-coronary-artery-disease-by-cardiac-computed-tomography
#13
T A Treibel, A Rossi, F Pugliese, L C Davies
Rapid technological advances in computed tomography (CT) have allowed CT coronary angiography (CTCA) to be delivered at low radiation dose and high diagnostic accuracy. Due to its high negative predictive value for coronary artery disease, it has become a gatekeeper for the assessment of patients with chest pain of recent onset. Second line functional assessment of a detected coronary stenosis relies mostly on other imaging modalities. Functional assessment of coronary artery disease by CT is therefore an attractive addition to CTCA...
July 25, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28595696/left-main-coronary-artery-compression-in-patients-with-pulmonary-arterial-hypertension-and%C3%A2-angina
#14
Nazzareno Galiè, Francesco Saia, Massimiliano Palazzini, Alessandra Manes, Vincenzo Russo, Maria Letizia Bacchi Reggiani, Gianni Dall'Ara, Enrico Monti, Fabio Dardi, Alessandra Albini, Andrea Rinaldi, Enrico Gotti, Nevio Taglieri, Cinzia Marrozzini, Luigi Lovato, Maurizio Zompatori, Antonio Marzocchi
BACKGROUND: Left main coronary artery (LMCA) compression is increasingly recognized as a cause of angina in pulmonary arterial hypertension (PAH). OBJECTIVES: This study aimed to evaluate the prevalence of LMCA extrinsic compression from a dilated pulmonary artery (PA) in patients with PAH and angina or angina-like symptoms, determine the usefulness of screening with computed tomography coronary angiography (CTCA), and assess the safety and efficacy of percutaneous coronary interventions (PCIs)...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28591028/haplotype-based-interaction-of-the-ppargc1a-and-ucp1-genes-is-associated-with-impaired-fasting-glucose-or-type-2-diabetes-mellitus
#15
Xiaoting Pei, Li Liu, Jialin Cai, Wenkai Wei, Yan Shen, Yaxuan Wang, Yanzi Chen, Panpan Sun, Mustapha Umar Imam, Zhiguang Ping, Xiaoli Fu
The aim of this study is to evaluate the effect of single-nucleotide polymorphisms (SNPs) of the PPARGC1A and UCP1 genes on impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM) and the haplotype-based interaction between these genes.A cross-sectional study was conducted by cluster sampling in Henan province, China. Based on the level of fasting plasma glucose (FPG) and the history of T2DM, the participants were divided into 2 groups; 83 individuals were in the IFG+DM group (those with IFG or T2DM) and 445 individuals were in the NFPG group (those with normal FPG)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28567355/impact-of-heart-rate-on-diagnostic-accuracy-of-second-generation-320-detector-computed-tomography-coronary-angiography
#16
Nitesh Nerlekar, Brian S Ko, Arthur Nasis, James D Cameron, Michael Leung, Adam J Brown, Dennis T L Wong, Philip J Ngu, John M Troupis, Sujith K Seneviratne
OBJECTIVE: To assess the impact of elevated heart rate (HR) on the diagnostic accuracy and image quality of second-generation 320-detector computed tomography coronary angiography (320-CTCA). METHODS: Consecutive patients with suspected coronary disease referred for invasive coronary angiography (ICA) were prospectively recruited and underwent 320-CTCA. Pre-scan beta-blockers were administered if native HR>80 bpm and post-scan cohorts stratified by traditional (HR ≤60 bpm) and elevated HR (61-80 bpm)...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28446550/national-institute-for-health-and-care-excellence-updates-the-stable-chest-pain-guideline-with-radical-changes-to-the-diagnostic-paradigm
#17
REVIEW
Adam Timmis, Carl A Roobottom
In the 2016 update of the stable chest pain guideline, the National Institute for Health and Care Excellence (NICE) has made radical changes to the diagnostic paradigm that it-like other international guidelines-had previously placed at the centre of its recommendations. No longer are quantitative assessments of the disease probability considered necessary to determine the need for diagnostic testing and the choice of test. Instead, the recommendation is for no diagnostic testing if chest pain is judged to be 'non-anginal' and CT coronary angiography (CTCA) in patients with 'typical' or 'atypical' chest pain with additional perfusion imaging only if there is uncertainty about the functional significance of coronary lesions...
July 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28379388/prevalence-of-obstructive-coronary-artery-disease-and-prognosis-in-patients-with-stable-symptoms-and-a-zero-coronary-calcium-score
#18
Tarun K Mittal, Alison Pottle, Ed Nicol, Mahmoud Barbir, Ben Ariff, Saeed Mirsadraee, Michael Dubowitz, Diana A Gorog, Piers Clifford, Soroosh Firoozan, Robert Smith, Simon Dubrey, Harmeet Chana, Jaymin Shah, Nigel Stephens, Christopher Travill, Andrew Kelion, Mini Pakkal, Adam Timmis
Aims: CT calcium scoring (CTCS) and CT cardiac angiography (CTCA) are widely used in patients with stable chest pain to exclude significant coronary artery disease (CAD). We aimed to resolve uncertainty about the prevalence of obstructive coronary artery disease and long-term outcomes in patients with a zero-calcium score (ZCS). Methods and results: Consecutive patients with stable cardiac symptoms referred for CTCS or CTCS and CTCA from chest pain clinics to a tertiary cardiothoracic centre were prospectively enrolled...
May 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28246175/symptoms-and-quality-of-life-in-patients-with-suspected-angina-undergoing-ct-coronary-angiography-a-randomised-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Michelle C Williams, Amanda Hunter, Anoop Shah, Valentina Assi, Stephanie Lewis, Kenneth Mangion, Colin Berry, Nicholas A Boon, Elizabeth Clark, Marcus Flather, John Forbes, Scott McLean, Giles Roditi, Edwin Jr van Beek, Adam D Timmis, David E Newby
BACKGROUND: In patients with suspected angina pectoris, CT coronary angiography (CTCA) clarifies the diagnosis, directs appropriate investigations and therapies, and reduces clinical events. The effect on patient symptoms is currently unknown. METHODS: In a prospective open-label parallel group multicentre randomised controlled trial, 4146 patients with suspected angina due to coronary heart disease were randomised 1:1 to receive standard care or standard care plus CTCA...
July 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28190514/transluminal-attenuation-gradient-and-corrected-models-in-coronary-ct-angiography-for-determining-stenosis-severity-a-primary-study-using-dual-source-ct
#20
COMPARATIVE STUDY
K Peng, N Xu, L Zhang, F Xiao, N Indima, J Zhang, Y Shen, W Peng, G Tang
AIM: To compare the incremental value of transluminal attenuation gradient (TAG), TAG with corrected contrast opacification (TAG-CCO), and TAG with exclusion of calcified coronary segments (TAG-ExC) in determining the stenosis severity of coronary arteries using coronary angiography (CAG) as the reference standard. MATERIALS AND METHODS: One hundred and fifteen patients who underwent computed tomography coronary angiography (CTCA) and confirmed by coronary angiography (CAG) were included in the retrospective analysis...
June 2017: Clinical Radiology
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