Document Detail


Predictive value of multislice computed tomography variables of atherosclerosis for ischemia on stress-rest single-photon emission computed tomography.
MedLine Citation:
PMID:  20660145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: previous studies have shown that the presence of stenosis alone on multislice computed tomography (MSCT) has a limited positive predictive value for the presence of ischemia on myocardial perfusion imaging (MPI). The purpose of this study was to assess which variables of atherosclerosis on MSCT angiography are related to ischemia on MPI.
METHODS AND RESULTS: both MSCT and MPI were performed in 514 patients. On MSCT, the calcium score, degree of stenosis (≥ 50% and ≥ 70% stenosis), and plaque extent and location were determined. Plaque composition was classified as noncalcified, mixed, or calcified. Ischemia was defined as a summed difference score (≥ 2 on a per-patient basis. Ischemia was observed in 137 patients (27%). On a per-patient basis, multivariate analysis showed that the degree of stenosis (presence of (≥ 70% stenosis, odds ratio=3.5), plaque extent and composition (mixed plaques (≥3, odds ratio=1.7; calcified plaques ≥ 3, odds ratio=2.0), and location (atherosclerotic disease in the left main coronary artery and/or proximal left anterior descending coronary artery, odds ratio=1.6) were independent predictors for ischemia on MPI. In addition, MSCT variables of atherosclerosis, such as plaque extent, composition, and location, had significant incremental value for the prediction of ischemia over the presence of ≥70% stenosis.
CONCLUSIONS: in addition to the degree of stenosis, MSCT variables of atherosclerosis describing plaque extent, composition, and location are predictive of the presence of ischemia on MPI.
Authors:
Joëlla E van Velzen; Joanne D Schuijf; Jacob M van Werkhoven; Bernhard A Herzog; Aju P Pazhenkottil; Eric Boersma; Fleur R de Graaf; Arthur J Scholte; Lucia J Kroft; Albert de Roos; Marcel P Stokkel; J Wouter Jukema; Philipp A Kaufmann; Ernst E van der Wall; Jeroen J Bax
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-21
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  3     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2010-12-23     Revised Date:  2011-09-06    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  718-26     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Atherosclerosis / complications,  radiography*
Contrast Media / diagnostic use
Coronary Angiography / methods
Coronary Stenosis / complications,  radiography
Coronary Vessels / radionuclide imaging
Exercise Test / methods*
Female
Humans
Image Enhancement / methods
Iopamidol / analogs & derivatives,  diagnostic use
Male
Middle Aged
Myocardial Ischemia / complications,  radionuclide imaging*
Myocardial Perfusion Imaging
Odds Ratio
Predictive Value of Tests
Rest
Tomography, Emission-Computed, Single-Photon / methods
Tomography, Spiral Computed / methods
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol; 78649-41-9/iomeprol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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