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Coronary CTA

Naser Ahmadi, Fereshteh Hajsadeghi, Vahid Nabavi, Garth Olango, Mohammed Molla, Matthew Budoff, Nutan Vaidya, Javier Quintana, Robert Pynoos, Peter Hauser, Rachel Yehuda
OBJECTIVE: Coronary-distensibility-index (CDI) impairments reflect endothelial-dependent process associated with vulnerable-plaque composition. This study investigates the relation of impaired-CDI with posttraumatic-stress-disorder (PTSD) and their predictive value for major-adverse-cardiovascular events (MACE). METHODS: This study involved 246 patients (age: 63±10 years, 12% women) with (n=50) and without (n=196) PTSD, who underwent computed-tomography angiography (CTA) to determine coronary artery disease (CAD) and CDI...
March 14, 2018: Psychosomatic Medicine
Shiwei Huang, Binglin Pan, He Zou, Wei Lin
BACKGROUND: Atrial fibrillation (AF) usually originates from pulmonary veins (PVs) but can also be caused by pulmonary veins outside, such as the coronary sinus (CS), the superior vena cava (SVC), and the ligament of Marshall. CASE PRESENTATION: A 69-year-old male with a history of palpitations for 10 years was referred to our institute because of its recurrence for half a day. A dynamic electrocardiogram revealed sinus rhythm (SR) and paroxysmal AF. Echocardiography demonstrated normal cardiac structure, and physical examination results were unremarkable...
March 13, 2018: BMC Cardiovascular Disorders
Fabian Plank, Christoph Beyer, Guy Friedrich, Markus Stühlinger, Florian Hintringer, Wolfgang Dichtl, Matthias Wildauer, Gudrun Feuchtner
OBJECTIVE: Vitamin K antagonists (VKA) are associated with increased vascular calcification which may lead to an elevated cardiovascular risk. If the direct anticoagulants (DOACs) have similar negative vascular effects is unknown. We evaluated the influence of different anticoagulation strategies on coronary artery disease (CAD) using coronary computed tomography angiography (CTA). METHODS: Overall 702 consecutive patients with non-valvular atrial fibrillation (AF) who underwent CTA for AF ablation planning were enrolled and stratified according to their anticoagulation into VKA, DOAC (all agents) and a control group without oral anticoagulation...
March 6, 2018: International Journal of Cardiology
Nam Ju Lee, Harold Litt
PURPOSE OF REVIEW: To compare outcomes between registries and randomized controlled trials of coronary computed tomographic angiography (CCTA)-based versus standard of care approaches to the initial evaluation of patients with acute chest pain. RECENT FINDINGS: Randomized trials have demonstrated CCTA to be a safe and efficient tool for triage of low- to intermediate-risk patients presenting to the emergency department with chest pain. Recent studies demonstrate heterogeneous result using different standard of care approaches for evaluation of hard endpoints in comparison with standard evaluation...
March 8, 2018: Current Cardiology Reports
Robbert W van Hamersvelt, Nienke G Eijsvoogel, Casper Mihl, Pim A de Jong, Arnold M R Schilham, Nico Buls, Marco Das, Tim Leiner, Martin J Willemink
We investigated the feasibility and extent to which iodine concentration can be reduced in computed tomography angiography imaging of the aorta and coronary arteries using low tube voltage and virtual monochromatic imaging of 3 major dual-energy CT (DECT) vendors. A circulation phantom was imaged with dual source CT (DSCT), gemstone spectral imaging (GSI) and dual-layer spectral detector CT (SDCT). For each scanner, a reference scan was acquired at 120 kVp using routine iodine concentration (300 mg I/ml). Subsequently, scans were acquired at lowest possible tube potential (70, 80, 80 kVp, respectively), and DECT-mode (80/150Sn, 80/140 and 120 kVp, respectively) in arterial phase after administration of iodine (300, 240, 180, 120, 60, 30 mg I/ml)...
March 8, 2018: International Journal of Cardiovascular Imaging
Allison D Ta, Li-Yueh Hsu, Hannah M Conn, Susanne Winkler, Anders M Greve, Sujata M Shanbhag, Marcus Y Chen, W Patricia Bandettini, Andrew E Arai
BACKGROUND: Dark rim artifacts in first-pass cardiovascular magnetic resonance (CMR) perfusion images can mimic perfusion defects and affect diagnostic accuracy for coronary artery disease (CAD). We evaluated whether quantitative myocardial blood flow (MBF) can differentiate dark rim artifacts from true perfusion defects in CMR perfusion. METHODS: Regadenoson perfusion CMR was performed at 1.5 T in 76 patients. Significant CAD was defined by quantitative invasive coronary angiography (QCA) ≥ 50% diameter stenosis...
March 8, 2018: Journal of Cardiovascular Magnetic Resonance
Domenico De Santis, Damiano Caruso, U Joseph Schoepf, Marwen Eid, Moritz H Albrecht, Taylor M Duguay, Akos Varga-Szemes, Andrea Laghi, Carlo N De Cecco
OBJECTIVES: To investigate the minimum iodine delivery rate (IDR) required to achieve diagnostic coronary attenuation (300 HU) with dual-energy coronary CTA. METHODS: Acquisitions were performed on a circulation phantom with a third- generation dual-source CT scanner. Contrast media was injected for a fixed time whilst IDRs varied from 1.0 to 0.3 gI/s in 0.1-gI/s intervals. Noise-optimized virtual monoenergetic imaging (VMI+) reconstructions from 40 to 90 keV in 5 keV increments were generated...
February 27, 2018: European Radiology
V Tuncay, R Vliegenthart, M A M den Dekker, G J de Jonge, J K van Zandwijk, P van der Harst, M Oudkerk, P M A van Ooijen
AIM: To assess the association of coronary artery geometry with the severity of coronary artery disease (CAD). METHODS: 73 asymptomatic individuals at increased risk of CAD due to peripheral vascular disease (18 women, mean age 63.5 ± 8.2 years) underwent coronary computed tomography angiography (coronary CTA) using first generation dual-source CT. Curvature and tortuosity of the coronary arteries were quantified using semi-automatically generated centerlines...
February 19, 2018: Journal of Cardiovascular Computed Tomography
Esma A Akin, Murat Osman, Amy L Ellenbogen
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans histiocytosis with deposition of lipid-laden macrophages in numerous organs. A 74-year-old man with a history of coronary artery disease, hypertension, and hyperlipidemia presented with nonspecific symptoms including back pain, nausea, vomiting, vertigo, and left leg pain. A neutrophil-predominant elevated WBC count and a bone biopsy revealing histiocytic proliferation positive for CD68 and CD163 and negative for S100 was noted. FDG PET/CT, MRA, and CTA images were obtained...
February 27, 2018: Clinical Nuclear Medicine
Toru Higaki, Takeshi Nakaura, Masafumi Kidoh, Hideaki Yuki, Yasuyuki Yamashita, Yuko Nakamura, Fuminari Tatsugami, Yasutaka Baba, Makoto Iida, Kazuo Awai
Arterial peak enhancement on contrast-enhanced CT (CECT) images is thought to be higher in patients with low cardiac function. Using computer simulations, we tested the hypothesis that the relationship between the cardiac index and the aortic peak CT number (PCTN) is affected by the contrast material (CM) injection duration. We created computer simulation software for the contrast enhancement of various organs and vessels based on the Bae pharmacokinetics model and implemented models for CM transmission within organs and CM diffusion in blood plasma based on the osmotic pressure...
2018: PloS One
Meiko Hoshino, Hideki Kawai, Masayoshi Sarai, Akiyo Sadato, Motoharu Hayakawa, Sadako Motoyama, Yasuomi Nagahara, Keiichi Miyajima, Hiroshi Takahashi, Junnichi Ishii, Ichiro Nakahara, Yuichi Hirose, Yukio Ozaki
AIMS: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA). METHODS: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7% male, aged 68.1±12...
February 16, 2018: Journal of Atherosclerosis and Thrombosis
Gianluca Pontone, Daniele Andreini, Andrea I Guaricci, Andrea Baggiano, Fabio Fazzari, Marco Guglielmo, Giuseppe Muscogiuri, Claudio Maria Berzovini, Annalisa Pasquini, Saima Mushtaq, Edoardo Conte, Giuseppe Calligaris, Stefano De Martini, Cristina Ferrari, Stefano Galli, Luca Grancini, Paolo Ravagnani, Giovanni Teruzzi, Daniela Trabattoni, Franco Fabbiocchi, Alessandro Lualdi, Piero Montorsi, Mark G Rabbat, Antonio L Bartorelli, Mauro Pepi
OBJECTIVES: The goal of this study was to evaluate the diagnostic accuracy of stress computed tomography myocardial perfusion (CTP) for the detection of functionally significant coronary artery disease (CAD) by using invasive coronary angiography (ICA) plus invasive fractional flow reserve (FFR) as the reference standard in consecutive intermediate- to high-risk symptomatic patients. BACKGROUND: Stress CTP recently emerged as a potential strategy to combine the anatomic and functional evaluation of CAD in a single scan...
February 9, 2018: JACC. Cardiovascular Imaging
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
Minjie Lu, Shuli Wang, Arlene Sirajuddin, Andrew E Arai, Shihua Zhao
BACKGROUND: Comparing to SPECT and MRI, with higher temporal and spatial resolution and development of radiation dose reduction, myocardial computed tomography perfusion has emerged as a potential method for evaluation of hemodynamic myocardial ischemia. This meta-analysis systematically analyzed the performance of dynamic CT myocardial perfusion (DCTMP) to diagnose myocardial ischemia (MI) with clinically established reference methods [MR/SPECT/PET perfusion and fractional flow reserve (FFR)] as the reference standard...
February 10, 2018: International Journal of Cardiology
Hironori Kitabata, Jonathon Leipsic, Manesh R Patel, Koen Nieman, Bernard De Bruyne, Campbell Rogers, Gianluca Pontone, Bjarne L Nørgaard, Jeroen J Bax, Gilbert Raff, Kavitha M Chinnaiyan, Mark Rabbat, Niels Peter Rønnow Sand, Philipp Blanke, Timothy A Fairbairn, Hitoshi Matsuo, Tetsuya Amano, Tomohiro Kawasaki, Yoshihiro Morino, Takashi Akasaka
BACKGROUND: To date, the clinical utility of coronary computed tomography angiography (CTA)-derived fractional flow reserve (FFRCT) has been limited to trials and single center experiences. We herein report the incidence of abnormal FFRCT (≤0.80) and the relationship of lesion-specific ischemia to subject demographics, symptoms, and degree of stenosis in the multicenter, prospective ADVANCE registry. METHODS: One thousand patients with suspected angina having documented coronary artery disease on coronary CTA and clinically referred for FFRCT were prospectively enrolled in the registry...
February 2, 2018: Journal of Cardiovascular Computed Tomography
Roel S Driessen, Wijnand J Stuijfzand, Pieter G Raijmakers, Ibrahim Danad, James K Min, Jonathon A Leipsic, Amir Ahmadi, Jagat Narula, Peter M van de Ven, Marc C Huisman, Adriaan A Lammertsma, Albert C van Rossum, Niels van Royen, Paul Knaapen
BACKGROUND: Atherosclerotic plaque characteristics may affect downstream myocardial perfusion, as well as coronary lesion severity. OBJECTIVES: This study sought to evaluate the association between quantitative plaque burden and plaque morphology obtained using coronary computed tomography angiography (CTA) and quantitative myocardial perfusion obtained using [15 O]H2 O positron emission tomography (PET), as well as fractional flow reserve (FFR) derived invasively...
February 6, 2018: Journal of the American College of Cardiology
Nicola Gaibazzi, Guido Pastorini, Andrea Biagi, Francesco Tafuni, Claudia Buffa, Silvia Garibaldi, Francesca Boffetti, Giorgio Benatti
BACKGROUND: Imaging stress tests are not ideally accurate to predict anatomically obstructive CAD, leading to a non-trivial rate of unnecessary iCA. This may depend on the threshold used to indicate iCA, and maybe CTA or, one step earlier, CT calcium score could spare most unnecessary iCA in only mildly positive cSE. We assessed the diagnostic accuracy of contrast stress-echocardiography (cSE) in comparison with invasive coronary angiography (iCA), and CT angiography (CTA) only in case of equivocal tests, to find hints helping reduce falsely positive cSE in the suspicion of coronary artery disease (CAD)...
February 6, 2018: Cardiovascular Ultrasound
Rolf Symons, Younhee Choi, Tyler E Cork, Mark A Ahlman, Marissa Mallek, David A Bluemke, Veit Sandfort
BACKGROUND: To optimize spectral coronary computed tomography angiography (CTA) for quantification of coronary artery plaque components. MATERIALS AND METHODS: Fifty-one subjects were prospectively enrolled (88.2% male) (NCT02740699). Dual energy coronary CTA was performed at 90/Sn150 kVp using a 3rd generation dual-source CT scanner (SOMATOM Force, Siemens Healthcare). Dual energy images were reconstructed with a) linear mixed blending of 90 and Sn150 kVp data, b) virtual monoenergetic algorithm from 40 to 150 keV (at 10- keV intervals), and c) noise-optimized virtual monoenergetic algorithm from 40 to 150 keV...
February 1, 2018: Journal of Cardiovascular Computed Tomography
Matthias Koopmann, Liane Hinrichs, Jan Olligs, Michael Lichtenberg, Lars Eckardt, Dirk Böse, Stefan Möhlenkamp, Johannes Waltenberger, Frank Breuckmann
BACKGROUND: Atrial fibrillation (AF) and coronary artery disease (CAD) may be encountered coincidently in a large portion of patients. However, data on coronary artery calcium burden in such patients are lacking. Thus, we sought to determine the value of cardiac computed tomography (CCT) in patients presenting with new-onset AF associated with an intermediate pretest probability for CAD admitted to a chest pain unit (CPU). METHODS: Calcium scores (CS) of 73 new-onset, symptomatic AF subjects without typical clinical, electrocardiographic, or laboratory signs of acute coronary syndrome (ACS) admitted to our CPU were analyzed...
January 24, 2018: European Journal of Medical Research
Dong Hyun Yang, Soo-Jin Kang, Hyun Jung Koo, Jihoon Kweon, Joon-Won Kang, Tae-Hwan Lim, Joonho Jung, Namkug Kim, June-Goo Lee, Seungbong Han, Jung-Min Ahn, Duk-Woo Park, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park, Gary S Mintz, Young-Hak Kim
OBJECTIVES: This study examined the incremental value of subtended myocardial mass (V sub ) as assessed by coronary computed tomography angiography (CTA) for identifying lesion-specific ischemia verified by invasive fractional flow reserve (FFR) in quantitative coronary CTA. BACKGROUND: FFR is determined not only by coronary stenosis severity, but also by V sub . One-step evaluation of combined V sub and coronary lesion morphology may improve the accuracy of coronary CTA for identifying ischemia-producing lesions...
January 12, 2018: JACC. Cardiovascular Imaging
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