Usefulness of the Agatston Score = 0 to Exclude Ischemic Cardiomyopathy in Patients With Heart Failure

Role of cardiac multidetector computed tomography in the exclusion of ischemic etiology in heart failure patients

“…18 Abunassar et al reported that in a population of 153 patients with a history of HF and low LVEF (<50%) all the 13 subjects with ischemic etiology had some degree of coronary calcification as assessed by the calcium score, whereas 30% of the subjects with non-ischemic cardiomyopathy had a Agatston score of zero. 18 CAD is believed to be the underlying cause in approximately two-thirds of patients with HF and low LVEF. 19,20 The distinction between ischemic and non-ischemic cardiomyopathy and assessment of CAD extent have major clinical implications in patients with dilated cardiomyopathy.…”

Coronary artery calcification on low-dose computed tomography: comparison of Agatston and Ordinal Scores

“…Many studies have shown that the Agatston Score of 0 indeed confers a very low likelihood of obstructive coronary artery disease [2,4,7,8,18,19]. Recommendations for the Ordinal Score Categories of 4-12 should include further evaluation by a preventive cardiologist (Fig.…”

Single low-dose CT scan optimized for rest-stress PET attenuation correction and quantification of coronary artery calcium

“…16 As well, PET is often used to evaluate patients with heart failure, and recent work has suggested that an Agatston calcium score = zero can also be used to exclude ischemic cardiomyopathy in patients with heart failure. 10 The calcium cohort scans were all performed following the attenuation cohort scans, which demonstrated that the single rest CTAC scan can be used for accurate reconstruction of rest and stress PET perfusion images. Interestingly, the highest difference in stress perfusion between rest CTAC and stress CTAC reconstruction in this study was observed in one patient excluded due to significant breathing motion artifact (end-inspiration) and resulting mis-registration of the post-stress CTAC scan with the stress PET data.…”

“…In the calcium cohort, ECG-gated cardiac CT was performed to obtain standard images of coronary artery calcium (CAC-CT), following the local clinical routine protocol as follows. 1,3,10 Medications were administered targeting a heart rate B65 beats per minute. Using the cardiac VCT scanner (GE Healthcare, Waukesha, WI), a non-contrast-enhanced, end-inspiration breath-hold, prospective ECG-gated image acquisition (400-800 mA, 120 kVp) was performed at 70% cardiac phase, and CT images were reconstructed with a 2.5-mm slice thickness and 25 cm field of view (FOV) centered over the heart.…”