title: A two center 320 slice CT study for evaluating coronary arteries in subjects with chronic atrial fibrillation: a comparison of prospective and retrospective ECG-gating acquisition.
abstract: OBJECTIVE
  To compare diagnostic-accuracy of prospective and retrospective-ECG-gated acquisition in 320-slice-CT for detecting coronary-artery stenosis in subjects with chronic-atrial-fibrillation (CAF) in a two-center study.
  
  
  METHODS
  53 CAF subjects who underwent 320-slice-CT, and invasive-coronary-angiogram (ICA) within 6-months (43 male; 69 ± 9 years; CHADS2 score 2.2 ± 1.3; CHA2DS2-VASc score 3.5 ± 1.6) in the two institutes were analyzed. In Institute-1, prospective-ECG-gated acquisition was routinely performed (N=33). In Institute-2, retrospective-ECG-gated acquisition was routinely performed (N=20). CT and ICA data were transferred to the analysis center and were analyzed by cardiologists blinded to the clinical-data.
  
  
  RESULTS
  Prevalence of >50 and >75% on ICA was 79 and 61% in Institute-1, and 30 and 15% in Institute-2, respectively. In a patient-by-patient analysis, Institute-2 had higher negative-predictive-value (NPV) and accuracy of >75% stenosis on CT in predicting >75% stenosis on ICA. In a vessel-by-vessel analysis, there were no significant-differences of sensitivity, specificity, positive-predictive-value (PPV) and NPV of >50% stenosis on CT in predicting >50% stenosis on ICA between both institutes. But sensitivity, specificity, and NPV of >75% stenosis on CT in predicting >75% stenosis on ICA were significantly higher in Institute-2 than in Institute-1. This is mainly because of more severe coronary-artery disease including calcification in Institute-1; there might also have been an influence of differences in scanning and reconstruction methods.
  
  
  CONCLUSIONS
  320-slice-CT shows relatively high diagnostic-accuracy for the detection of significant coronary-artery stenosis compared with ICA even in CAF subjects, in a two-center analysis. Retrospective-ECG-gated acquisition in 320-slice-CT shows significantly higher diagnostic-accuracy than prospective-ECG-gated acquisition for detection of >75% coronary-artery stenosis.
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan. Electronic address: nobusada@w8.dion.ne.jp.
authors.forename: Nobusada
authors.initials: N
authors.lastname: Funabashi
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Uehara
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takaoka
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Koya
authors.initials: K
authors.lastname: Ozawa
authors.affiliation: Department of Cardiology, Asahi General Hospital, I-1326, Asahi City, Chiba 289-2511, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kushida
authors.affiliation: Department of Cardiology, Asahi General Hospital, I-1326, Asahi City, Chiba 289-2511, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Kanda
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002908:Chronic Disease; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004562:Electrocardiography / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000592:standards; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: A two center 320 slice CT study; Chronic atrial fibrillation; Coronary arteries; Prospective and retrospective ECG-gating acquisition