Plaque assessment by coronary CT

Szilveszter, Bálint; Celeng, Csilla; Maurovich-Horvat, Pál

doi:10.1007/s10554-015-0741-8

Cited by 29 publications

(14 citation statements)

References 116 publications

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“…Further research should focus on measuring blood flow changes in the bifurcation area using the latest CCTA-derived computational fluid dynamics to allow robust conclusions to be drawn [29,30]. Fourth, only plaque distribution, plaque type and degree of lumen stenosis were analyzed in this study, while other parameters contributing to plaque vulnerability, such as plaque burden, plaque volume and lesion length were not assessed [31,32]. These variables should be included in CCTA analysis of coronary plaques in future studies.…”

Section: Discussionmentioning

confidence: 99%

Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease

Temov

Sun

2016

Int J Cardiovasc Imaging

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To explore the association between the left main coronary artery bifurcation angle and common atherosclerotic risk factors with regard to the development of coronary artery disease (CAD) using coronary computed tomography angiography (CCTA). A retrospective review of 196 CCTA cases (129 males, 67 females, mean age 58 ± 10.5 years) was conducted. The bifurcation angle between the left anterior descending (LAD) and left circumflex (LCx) was measured on two-dimensional (2D) and three-dimensional (3D) reconstructed images and the type of plaque and degree of lumen stenosis was assessed to determine the disease severity. An association between bifurcation angle and patient risk factors [gender, body mass index (BMI), hypertension, cholesterol, diabetes, smoking and family history] of CAD was also assessed to demonstrate the relationship between these variables. The mean bifurcation angle between the LAD and LCx was 79.40° ± 22.97°, ranging from 35.5° to 178°. Gender and BMI were found to have significant associations with bifurcation angle. Males were at 2.07-fold greater risk of having a >80° bifurcation angle and developing CAD than females (P = 0.003), and patients with high BMI (>25 kg/m(2)) were 2.54-fold more likely to have a >80° bifurcation angle than patients with a normal BMI (P = 0.001) and thus were at greater risk of developing CAD. There is a direct relationship between the left main coronary artery bifurcation angle and patient gender and BMI. Measurement of the bifurcation angle should be incorporated into clinical practice to identify patients at high risk of developing CAD.

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Section: Discussionmentioning

confidence: 99%

Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease

Temov

Sun

2016

Int J Cardiovasc Imaging

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“…This investigation has the advantage that it can detect plaques not visible on invasive coronary angiography. It can also to some degree determine if the plaque is stable or unstable [9]. CTA will make it possible to investigate the cause of “true” myocardial infarction by studying myocardial infarction determined by CMR imaging in relation to supplying coronary artery.…”

Section: Discussionmentioning

confidence: 99%

The value of a new cardiac magnetic resonance imaging protocol in Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA) – a case-control study using historical controls from a previous study with similar inclusion criteria

Tornvall

Brolin

Caidahl

et al. 2017

BMC Cardiovasc Disord

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BackgroundMyocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is common with a prevalence of 6% of all patients fulfilling the diagnosis of myocardial infarction. MINOCA should be considered a working diagnosis. Cardiac Magnetic Resonance (CMR) imaging has recently been suggested to be of great value to determine the cause behind MINOCA. The objectives of this paper are to describe the rationale behind the second Stockholm Myocardial Infarction with Normal Coronaries (SMINC-2) study and to discuss the protocol for investigation of MINOCA patients in the light of the recently published position paper from the European Society of Cardiology.MethodsThe SMINC-2 study is an open non-randomised study using historical controls for comparison. The primary aim is to prove that MINOCA patients investigated with the latest CMR imaging technique can achieve a diagnosis in 70% of all cases entirely by imaging. By including 150 patients we will have >80% chance to prove that the diagnostic accuracy can be improved by 20 absolute % with a p-value of less than 0.05 when compared with CMR imaging in the SMINC-1 study. Furthermore, in addition to invasive coronary angiography, coronary arteries are evaluated by computed tomography angiography to investigate coronary causes and questionnaires are used to describe Quality-of-Life (QoL). By January 1st 2017, 75 patients have been included.DiscussionWhether CMR imaging can provide a diagnosis to an adequate proportion of MINOCA patients is unknown. Well-defined inclusion and exclusion criteria will be used to compare a MINOCA cohort from the population with an appropriate control group. Positive results are likely to influence future guidelines of the management of MINOCA. Furthermore, the study will give mechanistic insights into MINOCA in particular in patients with “true” myocardial infarction and describe QoL in this vulnerable group of patients.Trial registrationClinical Trials NCT02318498.

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“…single letters) at the end of each classification to provide extra information on lesion vulnerability, presence of stents, coronary bypass grafts (CABG), or potentially non-diagnostic image quality. The modifier “V” indicates the presence of an atherosclerotic lesion, with at least two high-risk plaque features defined as positive remodeling, low-attenuation plaque, spotty calcification, or napkin-ring sign [15, 16]. In patients with prior coronary interventions, presence of coronary artery bypass graft (CABG) and stent are noted as “G” and “S”, respectively.…”

Section: Using the Cad-rads Classificationmentioning

confidence: 99%

CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography

et al. 2017

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Plaque assessment by coronary CT

Cited by 29 publications

References 116 publications

Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease

Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease

The value of a new cardiac magnetic resonance imaging protocol in Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA) – a case-control study using historical controls from a previous study with similar inclusion criteria

CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography

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