Accuracy of low-dose computed tomography coronary angiography using prospective electrocardiogram-triggering: first clinical experience.
OBJECTIVE
To evaluate the accuracy of low-dose computed tomography coronary angiography (CTCA) using prospective ECG-triggering for the assessment of coronary artery disease (CAD).


RESULTS
A total of 30 patients (19 males, 11 females, mean age 58.8 +/- 9.9 years) underwent low-dose CTCA and invasive coronary angiography (CA) [median 2 days (0, 41)]. Before CT scanning, intravenous beta-blocker was administered in 18 of 30 patients as heart rate (HR) was >65 b.p.m., achieving a mean HR of 55.7 +/- 7.9 b.p.m. CAD was defined as coronary artery narrowing > or =50%, using CA as standard of reference. The estimated mean effective radiation dose was 2.1 +/- 0.7 mSv (range: 1.0-3.3), yielding 96.0% (383/399) of evaluable segments. On an intention-to-diagnose-base, all non-evaluative segments were included in the analysis. Vessels with a non-evaluative segment and no further finding were censored as false positive. Patient-based analysis revealed sensitivity, specificity, positive predictive value, and negative predictive value of 100, 83.3, 90.0, and 100%, respectively. The respective values per vessel were 100, 88.9, 85.7, and 100%, respectively.


CONCLUSIONS
Prospective ECG-triggering allows low-dose CTCA and provides high diagnostic accuracy in the assessment of CAD in patients with stable sinus rhythm and a low heart rate.
Herzog
Bernhard A
BA
Cardiovascular Center, Raemistrasse 100, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
Husmann
Lars
L
Burkhard
Nina
N
Gaemperli
Oliver
O
Valenta
Ines
I
Tatsugami
Fuminari
F
Wyss
Christophe A
CA
Landmesser
Ulf
U
Kaufmann
Philipp A
PA
D016477:Artifacts; D017023:Coronary Angiography / Q000379:methods* / Q000592:standards; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000502:physiology / Q000528:radiation effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome