Dual-source computed tomography coronary angiography in patients with high heart rate.
Dual-source computed tomography coronary angiography in patients with high heart rate.
复制标题
高心率患者的双源计算机断层扫描冠状动脉造影。
DOI：
10.1007/s00380-013-0383-5
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发表时间：
2013
期刊：
影响因子：
1.5
通讯作者：
Yano M.
中科院分区：
文献类型：
--
作者：
Fujimura T;Miura T;Nao T;Yoshimura M;Nakashima Y;Okada M;Okamura T;Yamada J;Ohshita C;Wada Y;Matsunaga N;Matsuzaki M;Yano M.
虽然单源 64 层计算机断层扫描冠状动脉造影 (SSCTA) 需要降低心率 (HR)，但双源计算机断层扫描冠状动脉造影 (DSCTA) 即使在心动过速时也能获取图像。将心动过速期间 DSCTA 的准确性与心率降低时 SSCTA 的准确性进行比较。接受侵入性冠状动脉造影和 SSCTA 或 DSCTA 的患者被纳入其中。在 SSCTA 组中，使用 β 受体阻滞剂将心率降低至 <65 次/分钟 (bpm) (n = 27)，而在 DSCTA 组中，选择心率 > 65 次/分钟 (bpm) 的患者 (n = 27)。通过比较侵入性冠状动脉造影来计算显着冠状动脉狭窄的诊断准确性。使用双多普勒超声心动图评估这些患者的等容舒张时间（IRT）和舒张时间（DT）。在 SSCTA 中，敏感性为 89%，特异性为 99%，阳性预测值 (PPV) 为 94%，阴性预测值 (NPV) 为 98%。在 DSCTA 中，敏感性为 96%，特异性为 99%，PPV 为 91%，NPV 为 99%（所有 NS 与 SSCTA 相比）。当 HR >75 bpm 时，DT 显着缩短（<83 ms），但 IRT 保持 >85 ms。因此，由于其时间分辨率为 83 ms，IRT 阶段的图像重建在 DSCTA 中是可行的。 DSCTA 的高时间分辨率显示出与 SSCTA 相同的冠状动脉狭窄检测精度，且不会降低心率，因为它在 IRT 时进行图像重建。
Although single-source 64-multislice computed tomography coronary angiography (SSCTA) needs to reduce heart rate (HR), dual-source computed tomography coronary angiography (DSCTA) can acquire images even in tachycardia. The accuracy of DSCTA during tachycardia is compared to the accuracy of SSCTA at reduced HR. Patients who received invasive coronary angiography and either SSCTA or DSCTA were included. In the SSCTA group, HR was reduced to <65 beats per minute (bpm) with β-blocker (n= 27), while in the DSCTA group patients whose HR was >65 bpm were selected (n= 27). The diagnostic accuracy for significant coronary stenosis was calculated by comparing the invasive coronary angiography. Using dual-Doppler echocardiography, isovolumic relaxation time (IRT) and diastasis time (DT) were evaluated in these patients. In SSCTA, sensitivity was 89 %, specificity 99 %, the positive predictive value (PPV) 94 %, and the negative predictive value (NPV) was 98 %. In DSCTA, sensitivity was 96 %, the specificity was 99 %, PPV was 91 %, and NPV was 99 % (all NS compared to SSCTA). When HR was >75 bpm, DT was markedly shortened (<83 ms), however IRT was maintained >85 ms. Thus, the image reconstruction at the phase of IRT is feasible in DSCTA because of its temporal resolution of 83 ms. High temporal resolution of DSCTA shows equivalent accuracy of coronary stenosis detection to SSCTA, without reducing heart rate, because of its image reconstruction at IRT.