title: Comparison of dual source computed tomography versus intravascular ultrasound for evaluation of coronary arteries at least one year after cardiac transplantation.
abstract: This study evaluated the ability of dual-source computed tomography (DSCT) to detect coronary allograft vasculopathy (CAV) in heart transplant recipients using intravascular ultrasound (IVUS) as the standard of reference. Thirty patients with heart transplants (81% men, mean age 40 years) underwent DSCT (330-ms gantry rotation, 2 x 64 x 0.6-mm collimation, 60- to 80-ml contrast agent, no additional beta blockers) before invasive coronary angiography including IVUS of 1 vessel. Detection of CAV by DSCT was qualitatively defined as the presence of any coronary plaque. Mean heart rate during dual-source computed tomographic scanning was 80 +/- 14 beats/min. Four hundred fifty-nine segments with a vessel caliber >or=1.5 mm according to quantitative coronary angiography were evaluated in 30 patients. Of these, 96% were considered to have excellent or good image quality. IVUS detected CAV in 17 of 30 patients (57%) and in 41 of 110 coronary segments (37%). Compared to IVUS, sensitivity, specificity, positive and negative predictive values for the detection of CAV by DSCT were 85%, 84%, 76%, and 91%, respectively. In conclusion, DSCT permits the investigation of transplant recipients concerning the presence of CAV with good image quality and high diagnostic accuracy.
authors.affiliation: Department of Internal Medicine (Cardiology), University of Erlangen-Nuremberg, Erlangen, Germany. tiziano.schepis@uk-erlangen.de
authors.forename: Tiziano
authors.initials: T
authors.lastname: Schepis
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.forename: Michael
authors.initials: M
authors.lastname: Weyand
authors.forename: Philip
authors.initials: P
authors.lastname: Raum
authors.forename: Mohamed
authors.initials: M
authors.lastname: Marwan
authors.forename: Tobias
authors.initials: T
authors.lastname: Pflederer
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Rene
authors.initials: R
authors.lastname: Tandler
authors.forename: Markus
authors.initials: M
authors.lastname: Kondruweit
authors.forename: Dieter
authors.initials: D
authors.lastname: Ropers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006339:Heart Rate; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018084:Ultrasonography, Interventional; D055815:Young Adult