The Effect of Heart Rate on Exposure Window and Best Phase for Stress Perfusion Computed Tomography

Steveson, Chloe; Schuijf, Joanne D.; Vavere, Andrea L.; Mather, Richard T.; Caton, Teresa; Mehra, Vishal C.; Betoko, Aisha; Cox, Christopher; Lima, C. Joao A.C.; George, Richard Т. De

doi:10.1097/rct.0000000000000514

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…The administration of beta-blockers before a CCTA examination improves interpretability, which is mediated via the effect of lowering the heart rate and thereby decreasing cardiac motion. 27 In addition, beta-blocker therapy does not seem to affect the ability of myocardial perfusion imaging to identify ischemia. 28,29 However, if stress perfusion is performed as a stand-alone examination, administration of beta-blockers before the acquisition is not recommended.…”

Section: Beta-blockersmentioning

confidence: 99%

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Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography

Møller

Schuijf²,

Oyama‐Manabe

et al. 2022

Journal of Thoracic Imaging

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Dynamic myocardial computed tomography perfusion (DM-CTP) has good diagnostic accuracy for identifying myocardial ischemia as compared with both invasive and noninvasive reference standards. However, DM-CTP has not yet been implemented in the routine clinical examination of patients with suspected or known coronary artery disease. An important hurdle in the clinical dissemination of the method is the development of the DM-CTP acquisition protocol and image analysis. Therefore, the aim of this article is to provide a review of critical parameters in the design and execution of DM-CTP to optimize each step of the examination and avoid common mistakes. We aim to support potential users in the successful implementation and performance of DM-CTP in daily practice. When performed appropriately, DM-CTP may support clinical decision making. In addition, when combined with coronary computed tomography angiography, it has the potential to shorten the time to diagnosis by providing immediate visualization of both coronary atherosclerosis and its functional relevance using one single modality.

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Section: Beta-blockersmentioning

confidence: 99%

“…A critical issue in cardiac CT imaging is motion. Using retrospectively gated static perfusion, it was found that the best motion-free images were noted in mid-to-end diastole in 79% of cases and that the best phase occurs later in the R-R cycle as the heart rate increases 27…”

Section: Ct Perfusion For Detection Of Myocardial Ischemiamentioning

confidence: 99%

Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography

Møller

Schuijf²,

Oyama‐Manabe

et al. 2022

Journal of Thoracic Imaging

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CT Myocardial Perfusion Imaging: Arterial First-Pass Imaging

Schwarz

Altenburger

Gebhard

et al. 2019

Contemporary Medical Imaging

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Fractional flow reserve and myocardial perfusion by computed tomography: a guide to clinical application

Schuijf¹,

Carli

et al. 2017

European Heart Journal - Cardiovascular Imaging

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The aim of this paper is to provide a guide to the clinical application of the functional computed tomography (CT) techniques fractional flow reserve (CT FFR) and myocardial perfusion (CTP) in patients presenting for the evaluation of coronary artery disease (CAD). Both techniques have recently been introduced to complement coronary CT angiography (CTA) with physiological information. Evidence supporting their diagnostic accuracy accumulates at a fast pace, and both techniques are moving from research tools to clinical applications for specific subgroups of patients. As a consequence, the question that now emerges is how to optimally implement these techniques in the daily clinical workflow to maximize the benefit to patients. Given the inherent differences between both techniques in their underlying physical principles and methodology, as well as the types of pathophysiological information they provide, these techniques are not interchangeable. Rather, within the broad spectrum of patients presenting for CAD evaluation, both CT FFR and CTP may have their own optimized application where the highest benefit at the lowest risk and cost may be achieved. Therefore, we will review the physical principles and available clinical evidence of each technique, and propose how this information can be applied to the individual patient. Moreover, as techniques continue to mature, the combination of coronary CTA with CT FFR and/or CTP likely will become a powerful and accessible diagnostic tool for the detailed characterization of atherosclerotic disease providing a potentially more precise and personalized approach to patients with suspected CAD.

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The Effect of Heart Rate on Exposure Window and Best Phase for Stress Perfusion Computed Tomography

Abstract: Stress myocardial CTP imaging can be performed using prospective electrocardiography triggering, an exposure window of 75% to 95%, and β-blockade resulting in good or excellent image quality in the majority (80%) of patients while maintaining a low effective radiation dose.

Cited by 4 publications

References 25 publications

Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography

Technical Considerations for Dynamic Myocardial Computed Tomography Perfusion as Part of a Comprehensive Evaluation of Coronary Artery Disease Using Computed Tomography

CT Myocardial Perfusion Imaging: Arterial First-Pass Imaging

Fractional flow reserve and myocardial perfusion by computed tomography: a guide to clinical application

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