Accuracy of 64-Slice Computed Tomography for the Preoperative Detection of Coronary Artery Disease in Patients With Chronic Aortic Regurgitation
We studied the diagnostic accuracy of 64-slice computed tomography for the diagnosis of significant coronary artery disease (CAD) compared with conventional coronary angiography (CA) in patients with chronic aortic regurgitation (AR) referred for elective aortic valve surgery. Fifty consecutive pati...
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| Veröffentlicht in: | The American journal of cardiology 2007-08, Vol.100 (4), p.701-706 |
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| creator | Scheffel, Hans, MD Leschka, Sebastian, MD Plass, André, MD Vachenauer, Robert, MD Gaemperli, Oliver, MD Garzoli, Elisabeth, MD Genoni, Michele, MD Marincek, Borut, MD Kaufmann, Philipp, MD Alkadhi, Hatem, MD |
| description | We studied the diagnostic accuracy of 64-slice computed tomography for the diagnosis of significant coronary artery disease (CAD) compared with conventional coronary angiography (CA) in patients with chronic aortic regurgitation (AR) referred for elective aortic valve surgery. Fifty consecutive patients with chronic AR (38 men, mean age 54 ± 14 years) scheduled for valve surgery underwent 64-slice computed tomographic (CT) coronary angiography and CA. Significant stenosis was defined as a luminal diameter decrease >50%. Mean heart rate during CT scanning was 65.5 ± 7.4 beats/min. Mean Agatston score was 136 ± 278 (range 0 to 1207); prevalence of significant CAD in the study population was 26% (13 of 50 patients). Thirteen of 742 segments (1.8%) in 3 patients were considered nondiagnostic with computed tomography because of motion artifacts (n = 9) or calcium (n = 4). In a patient-based analysis taking nonevaluative segments as falsely positive, sensitivity, specificity, and positive and negative predictive values of computed tomography were 100%, 95%, 87%, and 100%, respectively. Preoperative CA could have been avoided in 70% of patients (35 of 50), CA would have been performed to confirm the CT diagnosis in 26% (13 of 50), and unnecessary CA would have been performed in 4% (2 of 50) on the basis of false-positive CT ratings. In conclusion, 64-slice CT coronary angiography provides high diagnostic accuracy for diagnosing significant CAD in patients with chronic AR and may be used as a filter test before valve surgery to decide whether CA should be performed. |
| doi_str_mv | 10.1016/j.amjcard.2007.03.087 |
| format | Article |
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Fifty consecutive patients with chronic AR (38 men, mean age 54 ± 14 years) scheduled for valve surgery underwent 64-slice computed tomographic (CT) coronary angiography and CA. Significant stenosis was defined as a luminal diameter decrease >50%. Mean heart rate during CT scanning was 65.5 ± 7.4 beats/min. Mean Agatston score was 136 ± 278 (range 0 to 1207); prevalence of significant CAD in the study population was 26% (13 of 50 patients). Thirteen of 742 segments (1.8%) in 3 patients were considered nondiagnostic with computed tomography because of motion artifacts (n = 9) or calcium (n = 4). In a patient-based analysis taking nonevaluative segments as falsely positive, sensitivity, specificity, and positive and negative predictive values of computed tomography were 100%, 95%, 87%, and 100%, respectively. Preoperative CA could have been avoided in 70% of patients (35 of 50), CA would have been performed to confirm the CT diagnosis in 26% (13 of 50), and unnecessary CA would have been performed in 4% (2 of 50) on the basis of false-positive CT ratings. In conclusion, 64-slice CT coronary angiography provides high diagnostic accuracy for diagnosing significant CAD in patients with chronic AR and may be used as a filter test before valve surgery to decide whether CA should be performed.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2007.03.087</identifier><identifier>PMID: 17697832</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Accuracy ; Adult ; Aged ; Aged, 80 and over ; Aortic Valve Insufficiency - complications ; Aortic Valve Insufficiency - diagnostic imaging ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Chronic Disease ; Coronary Angiography ; Coronary Disease - complications ; Coronary Disease - diagnostic imaging ; Coronary heart disease ; Diagnostic tests ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Preoperative Care - methods ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Severity of Illness Index ; Studies ; Tomography ; Tomography, X-Ray Computed - methods</subject><ispartof>The American journal of cardiology, 2007-08, Vol.100 (4), p.701-706</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. Aug 15, 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-9698c1504ac67f3b0b11683a88e29ef9ba2ec128b33f55132d3a8999d3249f5a3</citedby><cites>FETCH-LOGICAL-c475t-9698c1504ac67f3b0b11683a88e29ef9ba2ec128b33f55132d3a8999d3249f5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000291490700937X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19002525$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17697832$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scheffel, Hans, MD</creatorcontrib><creatorcontrib>Leschka, Sebastian, MD</creatorcontrib><creatorcontrib>Plass, André, MD</creatorcontrib><creatorcontrib>Vachenauer, Robert, MD</creatorcontrib><creatorcontrib>Gaemperli, Oliver, MD</creatorcontrib><creatorcontrib>Garzoli, Elisabeth, MD</creatorcontrib><creatorcontrib>Genoni, Michele, MD</creatorcontrib><creatorcontrib>Marincek, Borut, MD</creatorcontrib><creatorcontrib>Kaufmann, Philipp, MD</creatorcontrib><creatorcontrib>Alkadhi, Hatem, MD</creatorcontrib><title>Accuracy of 64-Slice Computed Tomography for the Preoperative Detection of Coronary Artery Disease in Patients With Chronic Aortic Regurgitation</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>We studied the diagnostic accuracy of 64-slice computed tomography for the diagnosis of significant coronary artery disease (CAD) compared with conventional coronary angiography (CA) in patients with chronic aortic regurgitation (AR) referred for elective aortic valve surgery. Fifty consecutive patients with chronic AR (38 men, mean age 54 ± 14 years) scheduled for valve surgery underwent 64-slice computed tomographic (CT) coronary angiography and CA. Significant stenosis was defined as a luminal diameter decrease >50%. Mean heart rate during CT scanning was 65.5 ± 7.4 beats/min. Mean Agatston score was 136 ± 278 (range 0 to 1207); prevalence of significant CAD in the study population was 26% (13 of 50 patients). Thirteen of 742 segments (1.8%) in 3 patients were considered nondiagnostic with computed tomography because of motion artifacts (n = 9) or calcium (n = 4). In a patient-based analysis taking nonevaluative segments as falsely positive, sensitivity, specificity, and positive and negative predictive values of computed tomography were 100%, 95%, 87%, and 100%, respectively. Preoperative CA could have been avoided in 70% of patients (35 of 50), CA would have been performed to confirm the CT diagnosis in 26% (13 of 50), and unnecessary CA would have been performed in 4% (2 of 50) on the basis of false-positive CT ratings. In conclusion, 64-slice CT coronary angiography provides high diagnostic accuracy for diagnosing significant CAD in patients with chronic AR and may be used as a filter test before valve surgery to decide whether CA should be performed.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve Insufficiency - complications</subject><subject>Aortic Valve Insufficiency - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Chronic Disease</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary heart disease</subject><subject>Diagnostic tests</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Prosthesis Implantation</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care - methods</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed - methods</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt2K1DAUgIso7rj6CEoQ9K41P23T3LgMXf9gwcVd0buQpqczGdumJunCvIWPbMoUF_bGi3AI-c7h5HwnSV4SnBFMyneHTA0HrVybUYx5hlmGK_4o2ZCKi5QIwh4nG4wxTQXJxVnyzPtDvBJSlE-TM8JLwStGN8mfrdazU_qIbIfKPL3pjQZU22GaA7To1g5259S0P6LOOhT2gK4d2AmcCuYO0CUE0MHYcUmvrbOjcke0dQFiuDQelAdkRnQdcRiDRz9M2KN6H0Gj0da6EMM32M1uZ4JaCj1PnnSq9_BijefJ948fbuvP6dXXT1_q7VWqc16EVJSi0qTAudIl71iDG0LKiqmqAiqgE42ioAmtGsa6oiCMtvFNCNEymouuUOw8eXuqOzn7ewYf5GC8hr5XI9jZy7IiZZnnPIKvH4AHO7sx9iYpw4zHIyJUnCDtrPcOOjk5M8RZSILl4kse5OpLLr4kZjL6inmv1uJzM0B7n7UKisCbFVBeq75zatTG33MiKi5oEbmLEwdxZncGnPQ6TlxDa1w0JFtr_tvK-wcVdG-iJdX_giP4f58m0lOJ5c2yXMtuYY6xYPwn-wtfDsuZ</recordid><startdate>20070815</startdate><enddate>20070815</enddate><creator>Scheffel, Hans, MD</creator><creator>Leschka, Sebastian, MD</creator><creator>Plass, André, MD</creator><creator>Vachenauer, Robert, MD</creator><creator>Gaemperli, Oliver, MD</creator><creator>Garzoli, Elisabeth, MD</creator><creator>Genoni, Michele, MD</creator><creator>Marincek, Borut, MD</creator><creator>Kaufmann, Philipp, MD</creator><creator>Alkadhi, Hatem, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20070815</creationdate><title>Accuracy of 64-Slice Computed Tomography for the Preoperative Detection of Coronary Artery Disease in Patients With Chronic Aortic Regurgitation</title><author>Scheffel, Hans, MD ; Leschka, Sebastian, MD ; Plass, André, MD ; Vachenauer, Robert, MD ; Gaemperli, Oliver, MD ; Garzoli, Elisabeth, MD ; Genoni, Michele, MD ; Marincek, Borut, MD ; Kaufmann, Philipp, MD ; Alkadhi, Hatem, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-9698c1504ac67f3b0b11683a88e29ef9ba2ec128b33f55132d3a8999d3249f5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve Insufficiency - complications</topic><topic>Aortic Valve Insufficiency - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Chronic Disease</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary heart disease</topic><topic>Diagnostic tests</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Prosthesis Implantation</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care - methods</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scheffel, Hans, MD</creatorcontrib><creatorcontrib>Leschka, Sebastian, MD</creatorcontrib><creatorcontrib>Plass, André, MD</creatorcontrib><creatorcontrib>Vachenauer, Robert, MD</creatorcontrib><creatorcontrib>Gaemperli, Oliver, MD</creatorcontrib><creatorcontrib>Garzoli, Elisabeth, MD</creatorcontrib><creatorcontrib>Genoni, Michele, MD</creatorcontrib><creatorcontrib>Marincek, Borut, MD</creatorcontrib><creatorcontrib>Kaufmann, Philipp, MD</creatorcontrib><creatorcontrib>Alkadhi, Hatem, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scheffel, Hans, MD</au><au>Leschka, Sebastian, MD</au><au>Plass, André, MD</au><au>Vachenauer, Robert, MD</au><au>Gaemperli, Oliver, MD</au><au>Garzoli, Elisabeth, MD</au><au>Genoni, Michele, MD</au><au>Marincek, Borut, MD</au><au>Kaufmann, Philipp, MD</au><au>Alkadhi, Hatem, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accuracy of 64-Slice Computed Tomography for the Preoperative Detection of Coronary Artery Disease in Patients With Chronic Aortic Regurgitation</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-08-15</date><risdate>2007</risdate><volume>100</volume><issue>4</issue><spage>701</spage><epage>706</epage><pages>701-706</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>We studied the diagnostic accuracy of 64-slice computed tomography for the diagnosis of significant coronary artery disease (CAD) compared with conventional coronary angiography (CA) in patients with chronic aortic regurgitation (AR) referred for elective aortic valve surgery. Fifty consecutive patients with chronic AR (38 men, mean age 54 ± 14 years) scheduled for valve surgery underwent 64-slice computed tomographic (CT) coronary angiography and CA. Significant stenosis was defined as a luminal diameter decrease >50%. Mean heart rate during CT scanning was 65.5 ± 7.4 beats/min. Mean Agatston score was 136 ± 278 (range 0 to 1207); prevalence of significant CAD in the study population was 26% (13 of 50 patients). Thirteen of 742 segments (1.8%) in 3 patients were considered nondiagnostic with computed tomography because of motion artifacts (n = 9) or calcium (n = 4). In a patient-based analysis taking nonevaluative segments as falsely positive, sensitivity, specificity, and positive and negative predictive values of computed tomography were 100%, 95%, 87%, and 100%, respectively. Preoperative CA could have been avoided in 70% of patients (35 of 50), CA would have been performed to confirm the CT diagnosis in 26% (13 of 50), and unnecessary CA would have been performed in 4% (2 of 50) on the basis of false-positive CT ratings. In conclusion, 64-slice CT coronary angiography provides high diagnostic accuracy for diagnosing significant CAD in patients with chronic AR and may be used as a filter test before valve surgery to decide whether CA should be performed.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17697832</pmid><doi>10.1016/j.amjcard.2007.03.087</doi><tpages>6</tpages></addata></record> |
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| subjects | Accuracy Adult Aged Aged, 80 and over Aortic Valve Insufficiency - complications Aortic Valve Insufficiency - diagnostic imaging Biological and medical sciences Cardiology. Vascular system Cardiovascular Cardiovascular disease Chronic Disease Coronary Angiography Coronary Disease - complications Coronary Disease - diagnostic imaging Coronary heart disease Diagnostic tests Endocardial and cardiac valvular diseases Female Heart Heart Valve Prosthesis Implantation Humans Male Medical sciences Middle Aged Predictive Value of Tests Preoperative Care - methods Prognosis Reproducibility of Results Retrospective Studies Severity of Illness Index Studies Tomography Tomography, X-Ray Computed - methods |
| title | Accuracy of 64-Slice Computed Tomography for the Preoperative Detection of Coronary Artery Disease in Patients With Chronic Aortic Regurgitation |
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