Comparison of Sixty-Four-Slice Multidetector Computed Tomographic Coronary Angiography to Coronary Angiography With Intravascular Ultrasound for the Detection of Transplant Vasculopathy

Shawn A. Gregory, Maros Ferencik, Stephan Achenbach, Robert W. Yeh, Udo Hoffmann, Ignacio Inglessis, Ricardo C. Cury, Koen Nieman, Iris A. McNulty, Josephine A. Laffan, Eugene V. Pomerantsev, Thomas J. Brady, Marc J. Semigran, Ik Kyung Jang

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Coronary allograft vasculopathy (CAV) is the most important limitation to long-term survival in adult heart transplant recipients and is difficult to detect without intravascular ultrasound (IVUS). We systematically evaluated the image quality of 64-slice multidetector computed tomographic (MDCT) coronary angiography in heart transplant recipients and tested the hypothesis that this modality is comparable to invasive coronary angiography with IVUS for the detection of CAV. Heart transplant recipients (n = 20) underwent invasive coronary angiography with IVUS and MDCT coronary angiography with a 64-slice scanner. Images were systematically analyzed for image quality and the presence of CAV. In addition, multidetector computed tomography and quantitative coronary angiography were used to measure lumen diameters at prespecified locations. Image quality analysis showed that, despite high mean heart rates (77 ± 7 beats/min) and body mass index (29.5 ± 5.3 kg/m2), 83% of coronary segments were graded as of excellent or good image quality. On average, 95 ± 9% of the overall visualized length of the coronary arteries was imaged without motion artifacts, and the mean contrast-to-noise ratio was 11.3 ± 4.6. Compared with IVUS, multidetector computed tomography had a sensitivity of 70%, specificity of 92%, positive predictive value of 89%, and negative predictive value of 77% for the detection of CAV. MDCT vessel diameter measurements correlated well with those obtained from quantitative coronary angiography (R2 = 0.89). In conclusion, 64-slice multidetector computed tomography provides good to excellent image quality in heart transplant recipients and has moderate to excellent test characteristics for the detection of CAV. Further, MDCT measurements of lumen diameters correlated well with quantitative coronary angiography.

Original languageEnglish (US)
Pages (from-to)877-884
Number of pages8
JournalAmerican Journal of Cardiology
Volume98
Issue number7
DOIs
StatePublished - Oct 1 2006
Externally publishedYes

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Coronary Angiography
Transplants
Allografts
Multidetector Computed Tomography
Artifacts
Noise
Coronary Vessels
Body Mass Index
Heart Rate
Sensitivity and Specificity
Survival
Transplant Recipients

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of Sixty-Four-Slice Multidetector Computed Tomographic Coronary Angiography to Coronary Angiography With Intravascular Ultrasound for the Detection of Transplant Vasculopathy. / Gregory, Shawn A.; Ferencik, Maros; Achenbach, Stephan; Yeh, Robert W.; Hoffmann, Udo; Inglessis, Ignacio; Cury, Ricardo C.; Nieman, Koen; McNulty, Iris A.; Laffan, Josephine A.; Pomerantsev, Eugene V.; Brady, Thomas J.; Semigran, Marc J.; Jang, Ik Kyung.

In: American Journal of Cardiology, Vol. 98, No. 7, 01.10.2006, p. 877-884.

Research output: Contribution to journalArticle

Gregory, SA, Ferencik, M, Achenbach, S, Yeh, RW, Hoffmann, U, Inglessis, I, Cury, RC, Nieman, K, McNulty, IA, Laffan, JA, Pomerantsev, EV, Brady, TJ, Semigran, MJ & Jang, IK 2006, 'Comparison of Sixty-Four-Slice Multidetector Computed Tomographic Coronary Angiography to Coronary Angiography With Intravascular Ultrasound for the Detection of Transplant Vasculopathy', American Journal of Cardiology, vol. 98, no. 7, pp. 877-884. https://doi.org/10.1016/j.amjcard.2006.04.027
Gregory, Shawn A. ; Ferencik, Maros ; Achenbach, Stephan ; Yeh, Robert W. ; Hoffmann, Udo ; Inglessis, Ignacio ; Cury, Ricardo C. ; Nieman, Koen ; McNulty, Iris A. ; Laffan, Josephine A. ; Pomerantsev, Eugene V. ; Brady, Thomas J. ; Semigran, Marc J. ; Jang, Ik Kyung. / Comparison of Sixty-Four-Slice Multidetector Computed Tomographic Coronary Angiography to Coronary Angiography With Intravascular Ultrasound for the Detection of Transplant Vasculopathy. In: American Journal of Cardiology. 2006 ; Vol. 98, No. 7. pp. 877-884.
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abstract = "Coronary allograft vasculopathy (CAV) is the most important limitation to long-term survival in adult heart transplant recipients and is difficult to detect without intravascular ultrasound (IVUS). We systematically evaluated the image quality of 64-slice multidetector computed tomographic (MDCT) coronary angiography in heart transplant recipients and tested the hypothesis that this modality is comparable to invasive coronary angiography with IVUS for the detection of CAV. Heart transplant recipients (n = 20) underwent invasive coronary angiography with IVUS and MDCT coronary angiography with a 64-slice scanner. Images were systematically analyzed for image quality and the presence of CAV. In addition, multidetector computed tomography and quantitative coronary angiography were used to measure lumen diameters at prespecified locations. Image quality analysis showed that, despite high mean heart rates (77 ± 7 beats/min) and body mass index (29.5 ± 5.3 kg/m2), 83{\%} of coronary segments were graded as of excellent or good image quality. On average, 95 ± 9{\%} of the overall visualized length of the coronary arteries was imaged without motion artifacts, and the mean contrast-to-noise ratio was 11.3 ± 4.6. Compared with IVUS, multidetector computed tomography had a sensitivity of 70{\%}, specificity of 92{\%}, positive predictive value of 89{\%}, and negative predictive value of 77{\%} for the detection of CAV. MDCT vessel diameter measurements correlated well with those obtained from quantitative coronary angiography (R2 = 0.89). In conclusion, 64-slice multidetector computed tomography provides good to excellent image quality in heart transplant recipients and has moderate to excellent test characteristics for the detection of CAV. Further, MDCT measurements of lumen diameters correlated well with quantitative coronary angiography.",
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AU - Achenbach, Stephan

AU - Yeh, Robert W.

AU - Hoffmann, Udo

AU - Inglessis, Ignacio

AU - Cury, Ricardo C.

AU - Nieman, Koen

AU - McNulty, Iris A.

AU - Laffan, Josephine A.

AU - Pomerantsev, Eugene V.

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N2 - Coronary allograft vasculopathy (CAV) is the most important limitation to long-term survival in adult heart transplant recipients and is difficult to detect without intravascular ultrasound (IVUS). We systematically evaluated the image quality of 64-slice multidetector computed tomographic (MDCT) coronary angiography in heart transplant recipients and tested the hypothesis that this modality is comparable to invasive coronary angiography with IVUS for the detection of CAV. Heart transplant recipients (n = 20) underwent invasive coronary angiography with IVUS and MDCT coronary angiography with a 64-slice scanner. Images were systematically analyzed for image quality and the presence of CAV. In addition, multidetector computed tomography and quantitative coronary angiography were used to measure lumen diameters at prespecified locations. Image quality analysis showed that, despite high mean heart rates (77 ± 7 beats/min) and body mass index (29.5 ± 5.3 kg/m2), 83% of coronary segments were graded as of excellent or good image quality. On average, 95 ± 9% of the overall visualized length of the coronary arteries was imaged without motion artifacts, and the mean contrast-to-noise ratio was 11.3 ± 4.6. Compared with IVUS, multidetector computed tomography had a sensitivity of 70%, specificity of 92%, positive predictive value of 89%, and negative predictive value of 77% for the detection of CAV. MDCT vessel diameter measurements correlated well with those obtained from quantitative coronary angiography (R2 = 0.89). In conclusion, 64-slice multidetector computed tomography provides good to excellent image quality in heart transplant recipients and has moderate to excellent test characteristics for the detection of CAV. Further, MDCT measurements of lumen diameters correlated well with quantitative coronary angiography.

AB - Coronary allograft vasculopathy (CAV) is the most important limitation to long-term survival in adult heart transplant recipients and is difficult to detect without intravascular ultrasound (IVUS). We systematically evaluated the image quality of 64-slice multidetector computed tomographic (MDCT) coronary angiography in heart transplant recipients and tested the hypothesis that this modality is comparable to invasive coronary angiography with IVUS for the detection of CAV. Heart transplant recipients (n = 20) underwent invasive coronary angiography with IVUS and MDCT coronary angiography with a 64-slice scanner. Images were systematically analyzed for image quality and the presence of CAV. In addition, multidetector computed tomography and quantitative coronary angiography were used to measure lumen diameters at prespecified locations. Image quality analysis showed that, despite high mean heart rates (77 ± 7 beats/min) and body mass index (29.5 ± 5.3 kg/m2), 83% of coronary segments were graded as of excellent or good image quality. On average, 95 ± 9% of the overall visualized length of the coronary arteries was imaged without motion artifacts, and the mean contrast-to-noise ratio was 11.3 ± 4.6. Compared with IVUS, multidetector computed tomography had a sensitivity of 70%, specificity of 92%, positive predictive value of 89%, and negative predictive value of 77% for the detection of CAV. MDCT vessel diameter measurements correlated well with those obtained from quantitative coronary angiography (R2 = 0.89). In conclusion, 64-slice multidetector computed tomography provides good to excellent image quality in heart transplant recipients and has moderate to excellent test characteristics for the detection of CAV. Further, MDCT measurements of lumen diameters correlated well with quantitative coronary angiography.

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