Author + information
- Received June 18, 2007
- Revision received August 16, 2007
- Accepted September 10, 2007
- Published online December 18, 2007.
- Ulrike Ropers, MD⁎,
- Dieter Ropers, MD⁎,
- Tobias Pflederer, MD⁎,
- Katharina Anders, MD†,
- Axel Kuettner, MD†,
- Nikolaos I. Stilianakis, MD§∥,
- Sei Komatsu, MD⁎,
- Willi Kalender, MD‡,
- Werner Bautz, MD†,
- Werner G. Daniel, MD, FACC⁎ and
- Stephan Achenbach, MD, FACC⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Stephan Achenbach, Department of Cardiology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany.
Objectives We evaluated the influence of heart rate on image quality and diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography.
Background Multidetector computed tomography (MDCT) coronary angiography has demonstrated an inverse relationship between heart rate and image quality. Dual-source CT provides a higher temporal resolution.
Methods One hundred patients were studied by DSCT (DEFINITION, Siemens Medical Solutions, Forchheim, Germany). A contrast-enhanced volume dataset was acquired (two tubes, 120 kV, 400 mAs/rot, collimation 64 × 0.6 mm). Datasets were evaluated concerning the presence of significant coronary stenoses and validated against invasive coronary angiography.
Results In 44 patients with a heart rate ≥65 beats/min, 566 of 616 coronary segments were evaluable (92%), whereas in 56 patients with a heart rate <65 beats/min, 777 of 778 coronary segments were evaluable (100%, p < 0.001). On a per-patient basis, 93% of patients (≥65 beats/min) and 100% of patients (<65 beats/min) were considered evaluable. By classifying unevaluable segments as positive for stenosis, per-patient sensitivity was 95% (19 of 20) for heart rates ≥65 beats/min and 100% (22 of 22) for heart rates <65 beats/min. Specificity was 87% (21 of 24) versus 76% (26 of 34), and overall diagnostic accuracy was 91% (40 of 44) versus 86% (48 of 56). None of these differences were statistically significant. Similarly, no difference in diagnostic accuracy was found in per-vessel and -segment analyses.
Conclusions In 100 patients studied without beta-blocker pre-medication, DSCT demonstrated slightly lower per-segment evaluability for high heart rates but no decrease in diagnostic accuracy for the detection of coronary artery stenoses.
- Received June 18, 2007.
- Revision received August 16, 2007.
- Accepted September 10, 2007.
- American College of Cardiology Foundation