Computed tomography coronary imaging as a gatekeeper for invasive coronary angiography in patients with newly diagnosed heart failure of unknown aetiology

Autor:	Koen Nieman, Boudewijn J. Krenning, Pim J. de Feyter, Admir Dedic, Kadir Caliskan, Gabriel P. Krestin, Lisan A. Neefjes, W. Bob Meijboom, Mohammed Ouhlous, Gert-Jan R. ten Kate, Olivier C. Manintveld
Přispěvatelé:	Radiology & Nuclear Medicine, Cardiology
Rok vydání:	2013
Předmět:	Male Cardiac Catheterization medicine.medical_specialty Coronary Artery Disease Anterior Descending Coronary Artery Coronary Angiography Coronary artery disease Left coronary artery medicine.artery Internal medicine medicine Humans Prospective Studies Angiocardiography Aged Heart Failure medicine.diagnostic_test business.industry Gold standard (test) Middle Aged medicine.disease Coronary arteries medicine.anatomical_structure Heart failure Cardiology Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Artery
Zdroj:	European Journal of Heart Failure, 15(9), 1028-1034. Wiley-Blackwell
ISSN:	1879-0844 1388-9842
Popis:	Aims To evaluate the accuracy of cardiac computed tomography (CT) in distinguishing CAD and non-CAD heart failure (HF) and its effectiveness as a gatekeeper for invasive coronary angiography (ICA). Methods and results We prospectively included 93 symptomatic patients with newly diagnosed HF of unknown aetiology (59 men; mean age 53 ± 13) and EF 60 mm (men) or >55 mm (women). In all patients, the CT calcium score (CTCS) was determined. CTCS = 0 excluded CAD HF. Additional CT coronary angiography (CTCA) was performed if CTCS >0. ICA was used as the gold standard for distinguishing between CAD and non-CAD HF in patients with >20% luminal diameter narrowing on CTCA. CAD HF was defined as >50% luminal diameter narrowing in either (i) the left main coronary artery or proximal left anterior descending coronary artery or (ii) in multiple coronary arteries. Diagnostic accuracy and follow-up data (20 ± 16 months) were collected for all patients. CTCS = 0 ruled out CAD HF in 43 patients (46%). The CT algorithm had 100% sensitivity, 95% specificity, 67% positive predictive value, and 100% negative predictive value for detecting CAD HF. Patients with CTCS = 0 or non-CAD HF on CTCA had no coronary events during follow-up, and ICA could have been safely avoided in 76 out of 93 patients (82%). Conclusion In patients with HF of unknown aetiology, cardiac CT combining CTCS and CTCA has high accuracy for detecting CAD HF and can be used effectively as a gatekeeper for ICA.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2fceb0e7f1f652173938d5ddb97b2d0f https://pure.eur.nl/en/publications/30287497-8f40-473a-938a-396bb6f4f750 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.