title: Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography.
abstract: OBJECTIVE
  We evaluated the accuracy of 64-slice computed tomography (CT) to identify ischaemic aetiology of heart failure (IHF).
  
  
  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.
  
  
  CONCLUSIONS
  Non-invasive 64-slice CT assessment of the extent of CAD may offer a valid alternative to angiography for the diagnosis of IHF.
authors.affiliation: Department of Cardiology, Marie Lannelongue Hospital, 133 avenue de la Resistance, 92350 Le Plessis Robinson, France. s.ghostine@ccml.fr
authors.forename: Saïd
authors.initials: S
authors.lastname: Ghostine
authors.forename: Christophe
authors.initials: C
authors.lastname: Caussin
authors.forename: Michel
authors.initials: M
authors.lastname: Habis
authors.forename: Yacoub
authors.initials: Y
authors.lastname: Habib
authors.forename: Chaoui
authors.initials: C
authors.lastname: Clément
authors.forename: Anne
authors.initials: A
authors.lastname: Sigal-Cinqualbre
authors.forename: Claude-Yves
authors.initials: CY
authors.lastname: Angel
authors.forename: Bernard
authors.initials: B
authors.lastname: Lancelin
authors.forename: André
authors.initials: A
authors.lastname: Capderou
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Paul
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*