The Prognostic Significance of Coronary CT Angiography

Abstract

Coronary computed tomography angiography (CTA) is an increasingly utilized, highly accurate noninvasive test for the diagnosis of coronary artery disease. Accumulating data have convincingly demonstrated that the presence, extent, and location of both obstructive and nonobstructive coronary atherosclerosis visualized on coronary CTA conveys powerful prognostic information, incremental to that provided by clinical variables and coronary calcium scoring. Proposed markers of future plaque instability and coronary risk, such as the degree of vessel remodeling and low-attenuation plaque volume, as well as measures of CT myocardial perfusion, may further improve the prognostic value of CTA. Ultimately, studies are needed to assess whether the prognostic information provided by coronary CTA testing results in sustained changes in patient and provider behaviors that cost effectively improve patient outcomes.

Cardiovascular disease in survivors of hematopoietic cell transplantation

“…Cardiac catheterization has long been considered the gold standard for assessing diseased arteries. However, it has limited value in screening for asymptomatic disease because, although it accurately depicts vessel lumen size, it is invasive and cannot detect significant plaque accumulation in the absence of stenosis . This has led to the development of less invasive methods, as reviewed below.…”

“…In non‐oncology populations, computed tomography (CT)‐based imaging (coronary artery calcium [CAC] scoring, CT angiography [CTA]) has emerged as an accurate, noninvasive measure of CAD risk in the intermediate‐risk group, helping to identify individuals at higher risk who may warrant more aggressive (eg, pharmacologic) therapy, while limiting interventions to lifestyle measures alone in those at lower risk …”

“…CTA allows a more direct, yet still noninvasive, measurement of total plaque in the coronary arteries . Each of the 17 coronary segments are visually assessed and classified on the basis of stenosis severity, and each plaque is classified as calcified, noncalcified, or mixed.…”

Traditional, forgotten and new left ventricular systolic function parameters on a 64-row multidetector cardiac computed tomography: A reproducibility study

“…PEV/ /phase duration [1/10 th of RR interval], mL/s) [9]. The derived parameters were calculated as the PER normalized for LVEDV (PER-V, 1/s), the PER normalized for LVM (PER-M, mL/g × s) and the PER normalized for LVEDV times the PER normalized for LVM product (PER-VM, mL/g × s 2 ).…”

“…Coronary computed tomography (CT) angiography is an established noninvasive method for coronary arteries imaging in patients with symptoms suggestive of coronary artery disease, both for diagnostic and prognostic purposes [1,2]. In a case of the retrospective scanning, a multi-detector CT (MDCT) examination permits the measurement of volumes, and assessment of cardiac function [3].…”