title: Etiological diagnosis of left ventricular dysfunction: computed tomography compared with coronary angiography and cardiac magnetic resonance.
abstract: OBJECTIVE
  To evaluate the capability of multidetector computed tomography to diagnose the coronary etiology of left ventricular dysfunction compared with using invasive coronary angiography and magnetic resonance.
  
  
  METHODS
  Forty consecutive patients with left ventricular dysfunction of uncertain etiology underwent invasive coronary angiography and contrast magnetic resonance. All patients were evaluated with multidetector computed tomography including coronary calcium presence and score, noninvasive coronary angiography, and myocardial tissue assessment.
  
  
  RESULTS
  The sensitivity and specificity of the presence of coronary calcium to identify left ventricular dysfunction was 100% and 31%, respectively. If an Agatston calcium score of >100 is taken, specificity increases to 58% with sensitivity still 100%. Sensitivity and specificity for coronary angiography by multidetector computed tomography was 100% and 96%, respectively; for identifying necrosis in contrast acquisition it was 57% and 100%, respectively; and in late acquisition, 84% and 96%, respectively. To identify coronary ventricular dysfunction with necrosis, the sensitivity and specificity was 92% and 100%, respectively.
  
  
  CONCLUSIONS
  Of all the diagnostic tools available in multidetector computed tomography, coronary angiography is the most accurate in determining the coronary origin of left ventricular dysfunction. A combination of coronary angiography and myocardial tissue study after contrast allows a single test to obtain similar information compared with the combination of invasive coronary angiography and contrast magnetic resonance.
authors.affiliation: Unidad de Imagen Cardiaca, ERESA, Valencia, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Estornell-Erill
authors.forename: Begoña
authors.initials: B
authors.lastname: Igual-Muñoz
authors.forename: Jose Vicente
authors.initials: JV
authors.lastname: Monmeneu-Menadas
authors.forename: Carlos
authors.initials: C
authors.lastname: Soriano-Navarro
authors.forename: Alfonso
authors.initials: A
authors.lastname: Valle-Muñoz
authors.forename: Juan V
authors.initials: JV
authors.lastname: Vilar-Herrero
authors.forename: Leandro
authors.initials: L
authors.lastname: Perez-Bosca
authors.forename: Rafael
authors.initials: R
authors.lastname: Paya-Serrano
authors.forename: Nieves
authors.initials: N
authors.lastname: Martinez-Alzamora
authors.forename: Francisco
authors.initials: F
authors.lastname: Ridocci-Soriano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D009336:Necrosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000209:etiology*