Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: Influence of calcification

Effect of Decrease in Heart Rate Variability on the Diagnostic Accuracy of 64-MDCT Coronary Angiography

“…Sensitivity decreased from 100% to 94.1%, specificity from 85.0% to 78.3%, positive predictive value from 92.5% to 86.5%, and negative predictive value from 100% to 90.0% among patients with heart rate variability greater than 2.7 beats/min compared with the lower heart rate variability group. Pearson correlation analysis revealed a significant correlation be- tivity of 91% and specificity of 94% were within the range of those in previous 64-MDCT studies [1][2][3][4][5][6][7].…”

“…Rapid advances in CT technology have generated immense interest in the use of CT to image coronary arteries. Studies [1][2][3][4][5][6][7] comparing 64-MDCT coronary angiography with invasive coronary angiography have proved the high diagnostic accuracy of CT in the detection of significant coronary stenosis, the sensitivity ranging from 73% to 99% [1,3] and the specificity from 93% to 98% [4,5]. Artifact-free visualization of coronary arteries, however, continues to be limited by coronary artery motion, which often impairs image quality at higher heart rates.…”

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

“…Currently, 15 studies have examined 64-slice technology for the evaluation of suspected CAD (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) (Figure 2). In these studies, 64-slice MDCT was able to assess 97% of all coronary artery segments visualized by both CCA and MDCT (Table 1), which is approximately 5% more than previous 16-slice technology.…”

“…Furthermore, when using patient-based analysis, defined as the presence of one or more significant coronary artery lesions in a study subject, sensitivity for 64-slice MDCT ranged between 88% to 100% in the 15 studies reviewed (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Additionally, in study populations with a low prevalence of CAD (32%), per-patient sensitivity remained very high (96%) (9).…”

Coronary calcification: Achilles’ heel in the assessment for coronary artery disease in patients with symptomatic angina?

“…Severe coronary calcification impedes the ability to adequately assess the degree of lumen compromise and has repeatedly been shown to limit the test's diagnostic capability [7][8][9]. Given the lack of additional information likely to be gleaned from CTCA in both patients with a high pretest probability as well as those with a very low pretest probability of coronary artery disease, the test remains most useful primarily in patients with an intermediate likelihood of cardiovascular disease and symptoms potentially attributable to CAD [10]. Hence, the necessity of the test in high-risk individuals with symptomatic angina (and thus high pretest probability of coronary disease) is difficult to justify on the basis of current data, notwithstanding occasional data which may indicate minimal or no effect of CS on the specificity of the test [11].…”