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Combined coronary and late-enhanced multidetector-computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast-enhanced cardiac magnetic resonance imaging

AIMS: To evaluate whether comprehensive evaluation of coronary anatomy and delayed enhancement (DE) by multidetector-computed tomography (MDCT) would allow determination of etiology of left ventricular dysfunction (LVD) as compared with coronary angiography (CA) and DE-magnetic resonance (CMR). METH...

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Detalles Bibliográficos
Autores principales: le Polain de Waroux, Jean-Benoît, Pouleur, Anne-Catherine, Goffinet, Céline, Pasquet, Agnès, Vanoverschelde, Jean-Louis, Gerber, Bernhard L.
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567022/
https://www.ncbi.nlm.nih.gov/pubmed/18762553
http://dx.doi.org/10.1093/eurheartj/ehn381
Descripción
Sumario:AIMS: To evaluate whether comprehensive evaluation of coronary anatomy and delayed enhancement (DE) by multidetector-computed tomography (MDCT) would allow determination of etiology of left ventricular dysfunction (LVD) as compared with coronary angiography (CA) and DE-magnetic resonance (CMR). METHODS AND RESULTS: Seventy-one consecutive patients (50 males, 59 ± 16 years) with LVD (ejection fraction: 26 ± 11%) of unknown etiology underwent MDCT, LGE (late Gd-DTPA-enhanced)-CMR and CA. Patients were classified into four groups according to coronary artery disease (CAD) by CA and LGE-CMR patterns. Patients (n = 24) with CAD and transmural or sub-endocardial DE by CMR were considered having definite ischaemic LVD (group 1). Patients (n = 36) without CAD by CA and with no/atypical LGE-CMR were considered non-ischaemic LVD (group 2). Further we identified four patients with transmural DE but no CAD (group 3) and seven patients with CAD but no DE (group 4). On per-patient basis, combined coronary and DE-MDCT had excellent agreement (κ = 0.89; P < 0.001) with CA/LGE-CMR to classify patients into the same four groups. Sensitivity, specificity and accuracy of MDCT were 97, 92 and 94%, respectively for detecting patients with definite (group 1) or likely (groups 3 and 4) ischaemic LVD. CONCLUSION: Combined coronary and DE-MDCT can accurately differentiate ischaemic vs. non-ischaemic etiology of LVD.