Document Detail


Clinical contributions of 64-slice computed tomography in the evaluation of cardiomyopathy of unknown origin.
MedLine Citation:
PMID:  19913770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Meta-analyses have confirmed the high performance of multislice computed tomography (MSCT) in coronary stenosis detection. Recent reports have described the study of left ventricular anatomy and function and coronary venous anatomy with MSCT.
AIMS: We sought to compare, in patients with cardiomyopathy of unknown origin, the performance of MSCT versus angiography for significant coronary artery disease detection and versus transthoracic echocardiography (TTE) for left ventricular anatomy and function evaluation, and to assess its ability to characterize coronary venous anatomy.
METHODS: Fifty-nine patients with cardiomyopathy (left ventricular ejection fraction [LVEF] less than or equal to 40%) of unknown origin, in sinus rhythm, underwent MSCT, TTE and coronary angiography.
RESULTS: Twenty-four (3%) of 724 analysable coronary segments (97%) and 12 (20%) patients had significant coronary artery disease. MSCT sensitivity, specificity, and positive and negative predictive values for coronary artery disease detection were 87.5%, 98.5%, 67.7% and 99.6% in the per-segment assessment and 100%, 91%, 75% and 100% in the per-patient evaluation, respectively. Statistical analyses showed good agreement between MSCT and TTE in LVEF measurement (33+/-10% vs 32+/-11%, p=0.4, mean difference=0.7%, limits of agreement+/-13.6%) and a small LVED diameter overestimation (65.0+/-9.3mm vs 63.6+/-9.4mm, p=0.03). MSCT allowed detection of the posterolateral vein in 86% of cases.
CONCLUSIONS: In selected patients presenting with idiopathic cardiomyopathy, MSCT is accurate for coronary artery disease detection and is a useful coronary venous imaging tool. MSCT studies of left ventricular function and morphology were mostly concordant with TTE measurements.
Authors:
Dominique Boulmier; Caroline Audinet; Jean-François Heautot; Antoine Larralde; David Veillard; Stéphanie Hamonic; Marc Bedossa; Guillaume Leurent; Mireille Garreau; Hervé Le Breton
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-02
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  102     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-16     Completed Date:  2010-03-01     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  685-96     Citation Subset:  IM    
Affiliation:
Service de cardiologie et maladies vasculaires, CCP-CHU de Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex 9, France. dominique.boulmier@chu-rennes.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiomyopathies / etiology,  physiopathology,  radiography*,  ultrasonography
Coronary Angiography*
Coronary Sinus / radiography*
Coronary Stenosis / complications,  physiopathology,  radiography*
Echocardiography
Female
Heart Ventricles / physiopathology,  radiography*,  ultrasonography
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Severity of Illness Index
Stroke Volume
Tomography, X-Ray Computed*
Ventricular Dysfunction, Left / etiology,  physiopathology,  radiography*,  ultrasonography
Ventricular Function, Left
Young Adult
Comments/Corrections
Comment In:
Arch Cardiovasc Dis. 2009 Oct;102(10):673-5   [PMID:  19913768 ]

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