title: Diagnostic performance of dual-source CT coronary angiography with and without heart rate control: systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography with and without the application of a β-blocker.
  
  
  METHODS
  An exact binomial rendition of the bivariate mixed-effects regression model was used to synthesize diagnostic test data.
  
  
  RESULTS
  The pooled sensitivity at the patient level was 0.98 [95% confidence intervals (CI): 0.97-0.99], and specificity 0.88 (95% CI: 0.84-0.91). The results showed that without heart rate control, the sensitivity and specificity at the patient level did not decrease (p = 0.27 and 0.56, respectively). At the artery level, no significant differences in sensitivity and specificity for studies with and without heart rate control were detected (p = 0.04 and 0.05, respectively). At the segment level, the specificity decreased without heart rate control (p = 0.03), whereas the sensitivity was not influenced (p = 0.63). The median radiation exposure was 2.6 mSv, with 1.6 mSv and 8 mSv for heart rate-controlled studies and uncontrolled studies, respectively.
  
  
  CONCLUSIONS
  DSCT coronary angiography without heart rate control has a similar excellent diagnostic performance at the patient level as that of heart rate control groups. However, controlling for heart rate to decrease radiation and to provide effective information for selecting the therapeutic strategy and risk stratification is recommended.
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, Jinan, Shandong Province, China.
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Medical Cardiology, Jinan Military General Hospital, Jinan, Shandong Province, China.
authors.forename: G-M
authors.initials: GM
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Qilu Children's Hospital of Shandong University, Jinan, Shandong Province, China.
authors.forename: J-S
authors.initials: JS
authors.lastname: Zhao
authors.affiliation: Department of Health Statistics, School of Public Health, Fourth Military Medical University, Xi'an, Shaanxi, China.
authors.forename: Z-W
authors.initials: ZW
authors.lastname: Jiang
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, Jinan, Shandong Province, China.
authors.forename: Z-H
authors.initials: ZH
authors.lastname: Peng
authors.affiliation: Department of Cardiology, General Hospital of the Second Artillery, Beijing, China.
authors.forename: Z-T
authors.initials: ZT
authors.lastname: Jin
authors.affiliation: Department of Medical Imaging, Jinan Military General Hospital, Jinan, Shandong Province, China. Electronic address: cjr.sungang@vip.163.com.
authors.forename: G
authors.initials: G
authors.lastname: Sun
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000319:Adrenergic beta-Antagonists