Dual source computed tomography coronary angiography in new onset cardiomyopathy

Abstract

AIM:To evaluate safety and utility of coronary computed tomography angiography (CCTA) compared to invasive coronary angiography (ICA) in new cardiomyopathy. METHODS:Eighteen patients (mean age 56.5 years, 10 males) who presented for evaluation of new onset heart failure with evidence of systolic dysfunction (ejection fraction < 40%) on echocardiography and recent ICA were prospectively enrolled. Patients with known coronary artery disease, atrial fibrillation, creatinine > 1.5 g/dL, and contraindication to intravenous contrast administration were excluded. CCTA was performed using a dual source 64-slice scanner. Mean heart rate was 75 beats per minute. Stenosis was graded for each coronary segment as: none, mild (< 50%), moderate (50%-70%), severe (> 70%), or non-evaluable. Ischemic cardiomyopathy (ICM) was diagnosed if severe stenosis was present in the left main, proximal left anterior descending artery, or two or more major arteries. RESULTS:Two patients were diagnosed with ICM by ICA. CCTA correctly identified 2 patients with ICM and 16 patients as non-ICM. CCTA successfully evaluated 240/246 coronary segments with an accuracy of 97.5%, sensitivity 70%, specificity 98.7%, positive predictive value of 70%, and negative predictive value of 98.7% for identifying severe stenosis on a per-segment level. CONCLUSION:Dual source 64-slice multi-detector CCTA is a safe, accurate, and non-invasive technique for diagnosing ICM in patients presenting during the acute phase of newly diagnosed cardiomyopathy.

Endoplasmic Reticulum Is Involved in Myocardial Injury in a Miniature Swine Model of Coronary Artery Stenosis Exposed to Acceleration-Associated Stress

“…The percentage of stenosis was calculated as [1-(vessel diameter of the target lesion/reference vascular diameter)]×100%. Swine were divided into groups according to their CAS degree: mild (stenosis of 20–50% of the reference vascular diameter), moderate (stenosis of 51–70%), and severe (stenosis of 71–90%) [ 19 ]. Chest was then sutured and the animals were allowed to recover under standard antibiotic therapy with benzathine penicillin (1.2 million IU/day) by intramuscular injection.…”

Diagnostic accuracy of 64 slice multidetector coronary computed tomographic angiography in left ventricular systolic dysfunction

“…Thus, CCTA is a promising noninvasive modality to work up heart failure patients for CAD, and has been deemed in CCTA guidelines as an appropriate imaging modality for the detection of CAD in low-to-intermediate pre-test probability patients with reduced LV systolic function [12] . A few studies support a high sensitivity for CAD in LV systolic dysfunction [13] , [14] , [15] , but they were performed in relatively small single-center populations. There is also concern that the presence of systolic dysfunction may make CCTA evaluation of CAD less reliable [16] , [17] .…”