Document Detail

Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy.
MedLine Citation:
PMID:  18292596     Owner:  NLM     Status:  MEDLINE    
AIMS: To prospectively investigate the diagnostic accuracy of dual-source computed tomography coronary angiography (CTCA) to diagnose coronary stenoses in relation to body mass index (BMI), Agatston score (AS), and heart rate (HR) as compared with catheter coronary angiography (CCA). METHODS AND RESULTS: Hundred and fifty consecutive patients (47 female, mean age 62.9 +/- 12.1 years) underwent dual-source CTCA without HR control. Patients were divided into subgroups depending on the median of their BMI (26.0 kg/m2), AS (194), and HR (66 b.p.m.). CCA was considered the standard of reference. Mean BMI was 26.5 +/- 4.2 kg/m2 (range 18.3-39.1 kg/m2), mean AS was 309 +/- 408 (range 0-4387), and HR was 68.5 +/- 12.6 b.p.m. (range 35-102 b.p.m.). Diagnostic image quality was found in 98.1% of all segments (2020/2059). Considering not-evaluative segments at CTCA as false-positive, overall per-patient sensitivity, specificity, positive, and negative predictive value were 96.6%, 86.8%, 82.6%, and 97.5%, respectively. High HR did not deteriorate diagnostic accuracy of CTCA. High BMI and AS were associated with a decrease in per-patient specificity to 84.1% and 77.8%, respectively, while sensitivity and negative predictive value remained high. CONCLUSION: Dual-source CTCA provides high diagnostic accuracy irrespective of the HR and serves as a modality to rule-out coronary artery stenoses even in patients with high BMI and AS.
Hatem Alkadhi; Hans Scheffel; Lotus Desbiolles; Oliver Gaemperli; Paul Stolzmann; André Plass; Gerhard W Goerres; Thomas F Luescher; Michele Genoni; Borut Marincek; Philipp A Kaufmann; Sebastian Leschka
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-02-21
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-17     Completed Date:  2008-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  766-76     Citation Subset:  IM    
Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, Zurich 8091, Switzerland.
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MeSH Terms
Aged, 80 and over
Body Mass Index
Calcinosis / complications*
Coronary Angiography / standards*
Coronary Artery Disease / complications*
Coronary Stenosis / radiography*
Heart Rate / physiology
Middle Aged
Obesity / complications*
Prospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed / standards*
Comment In:
Eur Heart J. 2008 Mar;29(6):701-3   [PMID:  18343798 ]

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