Abstract 16531: Detection of Significant Luminal Stenosis in Coronary Arteries in Subjects with Various Heart Rhythms by 320 Slice Computed Tomography Compared with Conventional Coronary Angiogram
Purpose: To evaluate luminal stenosis in coronary arteries in subjects with various heart rhythms including tachycardia and atrial fibrillation (Af) by 320 slice CT compared with qualitative coronary angiogram (QCA).
Materials and Methods: 86 consecutive subjects who underwent both 320 slice CT (Aquilion one) and QCA within 6 months and had no cardiac accident between them were enrolled (59 males, mean age 64±12 yrs, median Agatston score 134, sinus rhythm 91%, Af 9%, mean heart rate (HR, beats/min) 65±15, HR >65, 41%, hypertension, 55% hyperlipidemia, 48% diabetes mellitus, 27% smokers, 37%, and obese 29%). Visualized coronary vessels >1.5mm in diameter were analyzed, and >50% or >75% luminal stenosis detected on CT was compared with >50% and >75%, respectively, on QCA. Segments or vessels in which stents were implanted were excluded from the analyses.
Results: In a segment by segment analysis of 1206 segments, sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of >50% stenosis on CT for predicting >50% stenosis on QCA were 66, 98, 77, and 96%, respectively, and of >75% stenosis on CT for predicting >75% stenosis on QCA were 73, 98, 57, and 99%, respectively. In a vessel by vessel analysis of 191 vessels, sensitivity, specificity, PPV and NPV of >50% stenosis on CT for predicting >50% stenosis on QCA were 77, 94, 77, and 94%, respectively, and of >75% stenosis on CT for predicting >75% stenosis on QCA were 79, 94, 61, and 98%, respectively. In a patient by patient analysis of 50 subjects, sensitivity, specificity, PPV, and NPV of >50% stenosis on CT for predicting >50% stenosis on QCA were 88, 85, 83, and 89%, respectively, and of >75% stenosis on CT for predicting >75% stenosis on QCA were 85, 88, 77, and 93%, respectively. Errors were mainly in detecting distal lesions.
Conclusions: Even including subjects with tachycardia and Af, detection of stenosis of coronary arteries by 320 slice CT had higher specificity and NPV, but lower sensitivity and PPV than QCA.
- © 2010 by American Heart Association, Inc.