Comprehensive cardiac assessment with multislice computed tomography: evaluation of left ventricular function and perfusion in addition to coronary anatomy in patients with previous myocardial infarction
- M M Henneman1,
- J D Schuijf1,*,
- J W Jukema1,†,
- H J Lamb2,
- A de Roos2,
- P Dibbets3,
- M P Stokkel3,
- E E van der Wall1,†,
- J J Bax1
- 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- 2Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- 3Department of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Correspondence to:
Dr Jeroen J Bax
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands;
- Accepted 21 May 2006
- Published Online First 1 June 2006
Objective: To evaluate a comprehensive multislice computed tomography (MSCT) protocol in patients with previous infarction, including assessment of coronary artery stenoses, left ventricular (LV) function and perfusion.
Patients and methods: 16-slice MSCT was performed in 21 patients with previous infarction; from the MSCT data, coronary artery stenoses, (regional and global) LV function and perfusion were assessed. Invasive coronary angiography and gated single-photon emission computed tomography (SPECT) served as the reference standards for coronary artery stenoses and LV function/perfusion, respectively.
Results: 236 of 241 (98%) coronary artery segments were interpretable on MSCT. The sensitivity and specificity for detection of stenoses were 91% and 97%. Pearson’s correlation showed excellent agreement for assessment of LV ejection fraction between MSCT and SPECT (49 (13)% v 53 (12)%, respectively, r = 0.85). Agreement for assessment of regional wall motion was excellent (92%, κ = 0.77). In 68 of 73 (93%) segments, MSCT correctly identified a perfusion defect as compared with SPECT, whereas the absence of perfusion defects was correctly detected in 277 of 284 (98%) segments.
Conclusions: MSCT permits accurate, non-invasive assessment of coronary artery stenoses, LV function and perfusion in patients with previous infarction. All parameters can be assessed from a single dataset.
- LV, left ventricular
- LVEF, left ventricular ejection fraction
- MRI, magnetic resonance imaging
- MSCT, multislice computed tomography
- SPECT, single-photon emission computed tomography
Published Online First 1 June 2006
↵* Also the Interuniversity Cardiology Institute of the Netherlands, Utrecht, and the Department of Radiology, Leiden University Medical Center, Leiden
↵† Also the Interuniversity Cardiology Institute of the Netherlands, Utrecht
JDS is financially supported by The Netherlands Heart Foundation, The Hague, The Netherlands, grant number 2002B105. JWJ is financially supported by The Netherlands Heart Foundation, grant number 2001D032.
Competing interests: None declared.