Coronary Artery Motion During the Cardiac Cycle and Optimal ECG Triggering for Coronary Artery Imaging

Lü, Bin; Mao, Songshou; Zhuang, Nan; Bakhsheshi, Hamid; Yamamoto, Hideya; Takasu, Junichiro; Liu, Steve C. K.; Budoff, Matthew J.

doi:10.1097/00004424-200105000-00002

Cited by 161 publications

(109 citation statements)

References 24 publications

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“…Previous studies have shown that reducing average heart rate and heart rate variability is beneficial for reducing cardiac imaging artifacts (1,2). Despite these findings, little quantitative information is available about how heart rate and heart rate variation if affected by a cardiac CT scan acquisition.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Heart Rate and Heart Rate Variation During Cardiac CT Examinations

et al. 2008

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Rationale and Objectives-We sought to examine heart rate and heart rate variability during cardiac computed tomography (CT).Materials and Methods-Ninety patients (59.0 ± 13.5 years) underwent coronary CT angiography (CTA), with 52 patients also undergoing coronary artery calcium scanning (CAC). Forty-two patients with heart rate greater than 70 bpm were pretreated with oral β-blockers (in five patients, use of β-blocker was not known). Sixty-four patients were given sublingual nitroglycerin. Mean heart rate and percentage of beats outside a ±5 bpm region about the mean were compared between baseline (free breathing), prescan hyperventilation, and scan acquisition (breath-hold).Results-Mean scan acquisition time was 13.1 ± 1.5 seconds for CAC scanning and 14.2 ± 2.9 seconds for coronary CTA. Mean heart rate during scan acquisition was significantly lower than at baseline (CAC 58.2 ± 8.5 bpm; CTA 59.2 ± 8.8 bpm; baseline 62.8 ± 8.9 bpm; P < .001). The percentage of beats outside a ±5 bpm about the mean were not different between baseline and CTA scanning (3.5% versus 3.3%, P = .87). The injection of contrast had no significant effect on heart rate (58.2 bpm versus 59.2 bpm, P = .24) or percentage of beats outside a ±5 bpm about the mean (3.0% versus 3.3%, P = .64). No significant difference was found between gender and age groups (P > .05).Conclusions-Breath-holding during cardiac CT scan acquisition significantly lowers the mean heart rate by approximately 4 bpm, but heart rate variability is the same or less compared with normal breathing. KeywordsHeart rate; computed tomography; coronary angiography The patient's heart rate and heart rate variation play a very important role in cardiac computed tomography (CT) examinations, e.g., CT coronary artery calcium (CAC) and coronary CT angiography (CTA) (1-4), due to the limit of temporal resolution available in current CT systems (for single segment image reconstruction, this is as fast as 0.165 second using singlesource CT or 0.85 second using dual-source CT) (5,6). A study to evaluate the effect of heart rate on the quality of CT angiography exams obtained with 16-channel multidetector row CT (MDCT) demonstrated a significant negative correlation between mean heart rate and image quality (7). Besides mean heart rate, significant variations in heart rate (e.g., from 41 to 100

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Section: Discussionmentioning

confidence: 99%

Analysis of Heart Rate and Heart Rate Variation During Cardiac CT Examinations

et al. 2008

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“…Under the breath-holding condition, the greatest amount of coronary motion occurred in the right coronary artery (RCA), followed by the left circumflex (LCX), left main (LM), and left anterior descending (LAD) arteries, as also found in Ref. 16. The respiratory motion adds another global translation to the heart position.…”

Section: Coronary Motion Analysismentioning

confidence: 66%

Characterizing coronary motion and its effect on MR coronary angiography—Initial experience

Al–Kwifi

Stainsby

Foltz

et al. 2006

Magnetic Resonance Imaging

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Purpose: To characterize coronary artery motion as a prescan procedure to select the optimum scan setting that will produce high-resolution images. Materials and Methods:A 2D real-time scan was used to image the major coronary arteries during breath-holding and free-breathing conditions. With the use of the 2D images, motion displacement of each artery was measured along three axes. Motion data obtained from a computer simulation were used to estimate point-spread functions (PSFs) associated with different high-resolution spiral acquisition strategies, including real-time, cardiac-gated, and respiratory-gated acquisitions. The simulation output determined the optimum acquisition and scan parameters that would produce the highest-spatial-resolution images of the coronary arteries. The effects of heart rate (HR), extended breath-holding, and number of slices per heart cycle were also investigated.Results: Substantial variations in coronary motion occur among individuals, which directly influences the optimum parameters for a high-resolution scan. Lower HRs and longer breath-holds yield substantially increased spatial resolution. The maximum number of slices per heart cycle can also be determined to minimize slice-to-slice distortion. Conclusion:The results suggest that to obtain high-resolution coronary images, one should perform a prescan coronary-motion characterization for each individual so that the scan parameters can be optimized before data acquisition.

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“…Different coronary arterial segments have relatively complex motion patterns during the cardiac cycle (45)(46)(47). Accurate slice registration between the slice with the reinverted magnetization and the imaged slice is mandatory and may be compromised due to cardiac motion.…”

Section: Discussionmentioning

confidence: 99%