Potential Utility of Multidetector Computed Tomography to Identify both Cardiac Embolic Sources and Coronary Artery Disease in Patients with Embolic Stroke

Objectives: Our objective was to study the potential utility of multidetector computed tomography (MDCT) to identify both cardiac embolic sources and coronary artery disease (CAD) in embolic-stroke patients. Methods: We performed MDCT for 184 patients with embolic stroke but without known CAD. Twenty-six patients had atrial fibrillation. We investigated the prevalence of the potential source of the embolism and the coronary characteristics. Results: Overall, 64 potential embolic sources were detected in 59 patients (32.1%). Left atrial appendage thrombus, left ventricular thrombus and aortic atheroma were detected in 3.3, 0.5 and 15.8% of patients, respectively. Circulatory stasis and patent foramen ovale were detected in 8.7 and 6.5%, respectively. As for coronary calcium score, only 47 patients (25.5%) had a score of zero and 51 (27.7%) had a score of ≥400. Significant CAD was detected in 18 patients (9.8%). One hundred and thirty-seven (74.5%) had coronary plaques. The prevalence of positive remodeling, low-attenuation plaque, spotty calcification and a napkin-ring sign was 7.1, 1.6, 5.4 and 2.7%, respectively. Importantly, only 34 patients (13.0%) had no abnormalities detected by MDCT. Conclusions: Our results suggest that MDCT has potential to identify both cardiac embolic sources and CAD in patients with embolic stroke but without known CAD.

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Prevalence and Extent of Obstructive Coronary Artery Disease in Patients With Zero or Low Calcium Score Undergoing 64-Slice Cardiac Multidetector Computed Tomography for Evaluation of a Chest Pain Syndrome

The American Journal of Cardiology ◽

10.1016/j.amjcard.2006.08.060 ◽

2007 ◽

Vol 99 (4) ◽

pp. 472-475 ◽

Cited By ~ 119

Author(s):

Ronen Rubinshtein ◽

Tamar Gaspar ◽

David A. Halon ◽

Jacob Goldstein ◽

Nathan Peled ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Chest Pain ◽

Coronary Artery ◽

Multidetector Computed Tomography ◽

Obstructive Coronary Artery Disease ◽

Calcium Score ◽

Pain Syndrome ◽

Chest Pain Syndrome ◽

Artery Disease

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Relation between visceral fat and coronary artery disease evaluated by multidetector computed tomography

Atherosclerosis ◽

10.1016/j.atherosclerosis.2009.10.023 ◽

2010 ◽

Vol 209 (2) ◽

pp. 481-486 ◽

Cited By ~ 52

Author(s):

Mateus D. Marques ◽

Raul D. Santos ◽

Jose R. Parga ◽

Jose A. Rocha-Filho ◽

Luiz A. Quaglia ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Multidetector Computed Tomography ◽

Visceral Fat ◽

Artery Disease

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Evaluation of the relationship between coronary artery calcium score and coronary artery disease by multislice computed tomography

Dicle Medical Journal / Dicle Tip Dergisi ◽

10.5798/diclemedj.0921.2013.04.0346 ◽

2013 ◽

Vol 40 (4) ◽

pp. 632-636

Author(s):

Tuba Kartal ◽

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Multislice Computed Tomography ◽

Coronary Artery Calcium Score ◽

Calcium Score ◽

Artery Disease ◽

The Relationship

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Abstract 5813: Vascular Function Measured By Digital Thermal Monitoring Strongly Correlates with the Severity of Coronary Artery Disease Diagnosed by 64 Slice Multidetector Computed Tomography

Circulation ◽

10.1161/circ.118.suppl_18.s_108-c ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Naser Ahmadi ◽

Vivek Nuguri ◽

Sumithra Tirunagaram ◽

Anila Saeed ◽

Fereshteh Hajsadeghi ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Multidetector Computed Tomography ◽

Vascular Function ◽

List Type ◽

Thermal Monitoring ◽

Luminal Stenosis ◽

Artery Disease

Background: Digital Thermal Monitoring (DTM) of vascular reactivity is a new test of vascular function that correlates well with the Framingham Risk Score and subclinical coronary artery disease measured by the coronary calcium score. This study evaluates whether DTM correlates with the severity of coronary artery disease (CAD) measured by 64 slice multidetector computed tomography (MDCT). Methods: 151 patients, mean age 64±9 years, 69% male, were studied. Each underwent DTM during a 5 minute supra systolic arm-cuff occlusion and MDCT. Post-cuff deflation fingertip temperature rebound (TR) was correlated with CAD severity assessed by MDCT. Results: After adjusting for age, gender and CAD risk factors using logistic regression analysis, the odds ratio for TR in the lowest tertile vs. upper 2 tertiles was 1.3 (95% CI 0.89 –1.6, p=0.4) for mild CAC (luminal stenosis<30%), 2.7 (95% CI 1.2–3.9, p=0.0001) for moderate CAD (30 –70% luminal stenosis) and 6.94 (95% CI 2.2–10.7, p=0.0001) for severe CAD (luminal stenosis>70%) compared to normal coronaries. Additionally, TR was lower in coronary segments with mixed plaque compared to calcified plaque (0.43±0.17 vs. 0.91±0.19, p=0.001). Conclusions: Vascular dysfunction measured by DTM strongly correlates with the severity and characteristics of coronary plaques measured by MDCT, independent of age, gender and cardiac risk factors. DTM may be a useful tool for the identification of high risk patients, additional studies are warranted.

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