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Published on: February 16, 2016
Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography
Saïd Ghostine1, Christophe Caussin, Michel Habis
1Department of Cardiology, Marie Lannelongue Hospital, 133 avenue de la Resistance, 92350 Le Plessis Robinson, France. s.ghostine@ccml.fr
Insights
64-slice computed tomography (CT) accurately identifies ischaemic aetiology of heart failure (IHF) by assessing coronary artery disease (CAD). This non-invasive CT method shows high accuracy, potentially replacing traditional angiography for IHF diagnosis.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Ischaemic aetiology of heart failure (IHF) diagnosis often relies on invasive coronary angiography.
- Accurate non-invasive methods are needed to assess coronary artery disease (CAD) extent for IHF diagnosis.
Purpose of the Study:
- To evaluate the diagnostic accuracy of 64-slice computed tomography (CT) in identifying IHF.
- To compare CT's ability to detect significant coronary artery stenosis against quantitative coronary angiography.
Main Methods:
- Ninety-three patients with dilated cardiomyopathy underwent 64-slice CT and coronary angiography.
- CT accuracy for detecting >50% lumen narrowing was compared to angiography.
- IHF was defined by significant stenosis in major coronary arteries.
Main Results:
- CT demonstrated high accuracy in identifying patients with and without CAD (95% overall).
- For IHF identification, CT achieved 95% accuracy, with 90% sensitivity and 97% specificity.
- CT correctly assessed 90% of patients with IHF.
Conclusions:
- Non-invasive 64-slice CT assessment of CAD extent is a valid alternative to angiography for diagnosing IHF.
- CT offers a highly accurate and potentially less invasive approach for IHF diagnosis.
Aims:
We evaluated the accuracy of 64-slice computed tomography (CT) to identify ischaemic aetiology of heart failure (IHF).
Methods And Results:
Ninety-three consecutive patients in sinus rhythm with dilated cardiomyopathy but without suspicion of coronary artery disease (CAD) were enrolled when admitted for angiography. Accuracy of CT to detect significant stenosis (>50% lumen narrowing) was compared with quantitative coronary angiography. IHF was defined as a significant stenosis on left main or proximal left anterior descending artery or two or more vessels. Forty-three out of 1395 segments (3%) were heavily calcified and excluded. CT correctly assessed 103 of 142 (73%) significant stenosis and identified 46 of 50 (92%) patients without and 42 of 43 (98%) patients with CAD, 60 of 62 (97%) patients without and 28 of 31 (90%) patients with IHF. Overall, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT for identifying CAD by segment was 96, 73, 99, 92, and 97%, respectively; by patient was 95, 98, 92, 91, and 98%, respectively; and for identifying IHF was 95, 90, 97, 93, and 95%, respectively.
Conclusion:
Non-invasive 64-slice CT assessment of the extent of CAD may offer a valid alternative to angiography for the diagnosis of IHF.
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