Srichai MB, Fisch M, Hecht E, Slater J, Rachofsky E, Hays AG, Babb J, Jacobs JE. Dual source computed tomography coronary angiography in new onset cardiomyopathy. World J Radiol 2012; 4(6): 258-264 [PMID: 22778878 DOI: 10.4329/wjr.v4.i6.258]
Corresponding Author of This Article
Monvadi B Srichai, MD, NYU, Department of Radiology, New York University School of Medicine, 660 First Avenue, 2nd Floor, NY 10016, United States. srichai@alum.mit.edu
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Original Article
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World J Radiol. Jun 28, 2012; 4(6): 258-264 Published online Jun 28, 2012. doi: 10.4329/wjr.v4.i6.258
Dual source computed tomography coronary angiography in new onset cardiomyopathy
Monvadi B Srichai, Mark Fisch, Elizabeth Hecht, James Slater, Edward Rachofsky, Allison G Hays, James Babb, Jill E Jacobs
Monvadi B Srichai, James Babb, Jill E Jacobs, Department of Radiology, New York University School of Medicine, 660 First Avenue, NY 10016, United States
Monvadi B Srichai, James Slater, Department of Medicine (Cardiology Division), New York University School of Medicine, 560 First Avenue, NY 10016, United States
Mark Fisch, Good Samaritan Medical Care, 257 Lafayette Avenue, Suffern, NY 10901, United States
Elizabeth Hecht, Department of Radiology, University of Pennsylvania, 3400 Spruce Street, PA 19104, United States
Edward Rachofsky, Cardiology Associates of Somerset County, 745 Route 202-206, Bridgewater, NJ 08807, United States
Allison G Hays, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, United States
Author contributions: Srichai MB conceived the study design and was responsible for overseeing the project and writing the initial draft of the manuscript; Fisch M and Hays AG were responsible for coordination of data collection and initial analysis of the data; Hecht E and Jacobs JE were responsible for coronary CTA data collection and critical review of the manuscript; Slater J and Rachofsky E were responsible for X-ray coronary angiography data collection and critical review of the manuscript; Babb J was responsible for all statistical analyses performed.
Supported by Grants from the NYU Department of Radiology and Society of Computed Body Tomography and Magnetic Resonance
Correspondence to: Monvadi B Srichai, MD, NYU, Department of Radiology, New York University School of Medicine, 660 First Avenue, 2nd Floor, NY 10016, United States. srichai@alum.mit.edu
Telephone: +1-212-2630144 Fax: +1-212-2633838
Received: August 15, 2011 Revised: May 18, 2012 Accepted: May 25, 2012 Published online: June 28, 2012
Abstract
AIM: To evaluate safety and utility of coronary computed tomography angiography (CCTA) compared to invasive coronary angiography (ICA) in new cardiomyopathy.
METHODS: Eighteen patients (mean age 56.5 years, 10 males) who presented for evaluation of new onset heart failure with evidence of systolic dysfunction (ejection fraction < 40%) on echocardiography and recent ICA were prospectively enrolled. Patients with known coronary artery disease, atrial fibrillation, creatinine > 1.5 g/dL, and contraindication to intravenous contrast administration were excluded. CCTA was performed using a dual source 64-slice scanner. Mean heart rate was 75 beats per minute. Stenosis was graded for each coronary segment as: none, mild (< 50%), moderate (50%-70%), severe (> 70%), or non-evaluable. Ischemic cardiomyopathy (ICM) was diagnosed if severe stenosis was present in the left main, proximal left anterior descending artery, or two or more major arteries.
RESULTS: Two patients were diagnosed with ICM by ICA. CCTA correctly identified 2 patients with ICM and 16 patients as non-ICM. CCTA successfully evaluated 240/246 coronary segments with an accuracy of 97.5%, sensitivity 70%, specificity 98.7%, positive predictive value of 70%, and negative predictive value of 98.7% for identifying severe stenosis on a per-segment level.
CONCLUSION: Dual source 64-slice multi-detector CCTA is a safe, accurate, and non-invasive technique for diagnosing ICM in patients presenting during the acute phase of newly diagnosed cardiomyopathy.
