[Cardiac computed tomography - Current diagnostic role in cardiology]

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Interventional Cardiology

Background:

• Computed tomography (CT) cardiac imaging necessitates synchronization with the electrocardiogram (ECG) for optimal image acquisition.
• ECG-gated reconstruction or triggered acquisition are standard methods for cardiac CT.
• Cardiac CT has evolved beyond coronary artery imaging to include guidance for structural heart interventions.

Purpose of the Study:

• To review the applications of cardiac CT, focusing on coronary artery imaging and structural heart interventions.
• To highlight the diagnostic capabilities of contrast-enhanced coronary CT angiography for stenosis and plaque visualization.
• To emphasize the role of CT in planning and executing structural heart interventions.

Main Methods:

• Review of current literature and clinical practices in cardiac CT.
• Discussion of ECG-gating techniques for cardiac CT acquisition and reconstruction.
• Analysis of CT's utility in diagnosing coronary artery disease and guiding interventions.

Main Results:

• Contrast-enhanced coronary CT is effective for identifying and excluding coronary stenoses in patients with suspected or acute coronary artery disease.
• CT can visualize non-obstructive coronary atherosclerotic plaque, informing risk stratification and treatment strategies like statin therapy.
• Cardiac CT is crucial for planning structural heart interventions, including transcatheter aortic valve implantation, enhancing safety and outcomes.

Conclusions:

• Cardiac CT is a versatile imaging modality with established roles in diagnosing coronary artery disease and guiding complex structural heart interventions.
• The ability to visualize coronary anatomy and plaque provides valuable information for patient management and risk modification.
• CT imaging is indispensable for the successful planning and execution of modern structural heart procedures, optimizing patient outcomes.