Author + information
- Kumiko Hirata,
- Hiroko Nakanishi,
- Makoto Orii,
- Kohei Ishibashi,
- Takashi Yamano,
- Takashi Tanimoto,
- Yasushi Ino,
- Tomoyuki Yamaguchi,
- Toshio Imanishi and
- Takashi Akasaka
Computed tomography (CT) angiography provides high sensitivity for detection of coronary stenosis, while the specificity is relatively low. Therefore, we hypothesized that combination of coronary flow velocity reserve (CFVR)/CT angiography might be helpful.
This study aimed to determine the incremental value of CFVR by transthoracic echocardiography when used with CT angiography for detecting stenosis of 3 major coronary arteries compared with invasive quantitative coronary angiography (QCA).
The study group consisted of 60 consecutive patients with suspected coronary artery disease who were scheduled to undergo coronary angiography. CT angiography and CFVR measurement by transthoracic echocardiography were performed within 48 hours before invasive angiography. CT angiography were acquired using 64-detector row CT and CFVR were measured using adenosine triphosphate. Cut-off values of CFVR to predict >50% stenosis on invasive QCA were determined using receiver operating characteristic curve.
Adequate CFVR measurements were obtained in 165 (92%) of 180 vessels. CFVR correctly identified 44/52(85%) DS≥50% stenosis and 94/104(90%) DS<50% stenosis on invasive QCA. Per-vessel sensitivity, specificity, positive, and negative predictive values of CFVR were 85, 83, 70, and 92%, and those of CT angiography were 90, 72, 59 and 94%, respectively. The combination of >50% stenosis on CT angiography and impaired CFVR was 97% specific for >50% stenosis, while the presence of <50% stenosis on CT angiography and preserved CFVR on was 100% specific for exclusion of >50% stenosis on invasive QCA.
In vessels, where CT angiography and CFVR are concordant, CFVR/CT angiography is highly accurate in the detection and exclusion of coronary stenosis. Thus, CFVR measurement could improve the diagnostic accuracy of CT angiography to detect stenosis in 3 major coronary arteries.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Echocardiographic Imaging of Patients with CAD: II
Abstract Category: 18. Imaging: Echo
Presentation Number: 1266-316
- 2013 American College of Cardiology Foundation