scholarly journals Incremental Diagnostic Value of Regional Left Ventricular Function Over Coronary Assessment by Cardiac Computed Tomography for the Detection of Acute Coronary Syndrome in Patients With Acute Chest Pain

2010 ◽  
Vol 3 (4) ◽  
pp. 375-383 ◽  
Author(s):  
Sujith K. Seneviratne ◽  
Quynh A. Truong ◽  
Fabian Bamberg ◽  
Ian S. Rogers ◽  
Michael D. Shapiro ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Left Ventricular Function ◽  
Cardiac Computed Tomography ◽  
Acute Chest Pain ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Regional Left Ventricular Function ◽  
Coronary Syndrome

scholarly journals Copeptin Does Not Add Diagnostic Information to High-Sensitivity Troponin T in Low- to Intermediate-Risk Patients with Acute Chest Pain: Results from the Rule Out Myocardial Infarction by Computed Tomography (ROMICAT) Study

2011 ◽  
Vol 57 (8) ◽  
pp. 1137-1145 ◽  
Author(s):  
Mahir Karakas ◽  
James L Januzzi ◽  
Julia Meyer ◽  
Hang Lee ◽  
Christopher L Schlett ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Predictive Value ◽  
Troponin T ◽  
Cardiac Computed Tomography ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Intermediate Risk ◽  
Coronary Syndrome

PURPOSE Copeptin, a stable peptide derived from the AVP precursor, has been linked to presence and severity of myocardial ischemia. We sought to evaluate the predictive value of copeptin and its incremental value beyond that of high-sensitivity cardiac troponin T (hs-cTnT) in patients with acute chest pain and low to intermediate risk for acute coronary syndrome (ACS). METHODS We recruited patients who presented with acute chest pain to the emergency department and had a negative initial conventional troponin T test (<0.03 μg/L). In all patients, hs-cTnT and copeptin measurements were taken. Each patient also underwent cardiac computed tomography (CT) and coronary angiography. RESULTS Baseline copeptin concentrations, in contrast to hs-cTnT, were not significantly higher in patients with ACS than in those without (P = 0.24). hs-cTnT showed an earlier rise in patients with ACS than copeptin, when analyses were stratified by time. A copeptin concentration ≥7.38 pmol/L had a negative predictive value (NPV) of 94% and a sensitivity of 51%, whereas hs-cTnT (≥13.0 pg/mL) had a NPV of 96% and a sensitivity of 63%. The combination of copeptin and hs-cTnT resulted in a lower diagnostic accuracy than hs-cTnT alone. Finally, on cardiac CT, copeptin concentrations were not associated with coronary artery morphology, although they were related to the presence of left ventricular dysfunction (P = 0.02). CONCLUSIONS Among patients with acute chest pain and low to intermediate risk for ACS, copeptin concentrations are not independently predictive of ACS and do not add diagnostic value beyond that of hs-cTnT measurements.

Diagnostic Capacity of 64-Slice Multidetector Computed Tomography for Acute Coronary Syndrome in Patients Presenting with Acute Chest Pain

Cardiology ◽  
2009 ◽  
Vol 112 (3) ◽  
pp. 211-218 ◽  
Author(s):  
Koji Ueno ◽  
Toshihisa Anzai ◽  
Masahiro Jinzaki ◽  
Minoru Yamada ◽  
Takashi Kohno ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Multidetector Computed Tomography ◽  
Acute Chest Pain ◽  
Coronary Syndrome ◽  
Diagnostic Capacity

scholarly journals Current Role of Computed Tomography in the Evaluation of Acute Coronary Syndrome

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 266
Author(s):  
Min Ji Son ◽  
Seung Min Yoo ◽  
Dongjun Lee ◽  
Hwa Yeon Lee ◽  
In Sup Song ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Acute Chest Pain ◽  
Review Article ◽  
Current Role ◽  
Coronary Syndrome ◽  
Ct Findings

This review article provides an overview regarding the role of computed tomography (CT) in the evaluation of acute chest pain (ACP) in the emergency department (ED), focusing on characteristic CT findings.

scholarly journals Clinical utility of two-phase computed tomography angiography for the detection of myocardial perfusion defects related to acute coronary syndrome in patients with acute chest pain: a case series

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Enrique Vallejo ◽  
Christian Buelna-Cano
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Computed Tomography Angiography ◽  
Case Series ◽  
Acute Chest Pain ◽  
Cardiac Biomarkers ◽  
Two Phase ◽  
Imaging Protocol ◽  
Coronary Syndrome

Abstract Background Evaluation of acute chest pain (ACP) in the emergency department is a major health issue and differential diagnosis remains challenging for the physician, particularly in patients with atypical symptoms and inconclusive changes in electrocardiogram (ECG) or biomarkers levels. Case summary We present the potential value of the two-phase computed tomography angiography (TP-CTA) imaging protocol done in six different patients evaluated with ACP and underwent non-gated or gated computed tomography angiography (CTA) to exclude pulmonary embolism (PE), acute aortic syndrome (AAS), or acute coronary syndrome (ACS). All patients had new-onset chest pain and atypical clinical presentation with non-diagnostic ECG and initially negative or near-normal cardiac biomarkers. Discussion The evaluation of myocardial computed tomography perfusion (MCTP) using TP-CTA imaging protocol might open a new diagnostic approach to evaluate MCTP in patients with ACP related to PE, AAS, or ACS.

Abstract 2546: Resting Regional Left Ventricular Function as Assessed using Cardiac 64-slice Computed Tomography to Predict Acute Coronary Syndrome in Patients with Acute Chest Pain

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ian S Rogers ◽  
Sujith K Seneviratne ◽  
Michael D Shapiro ◽  
Fabian Bamberg ◽  
Sam J Lehman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Left Ventricular Function ◽  
Acute Chest Pain ◽  
Coronary Plaque ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Dysfunction ◽  
History Of ◽  
Ischemic Ecg

Background : Cardiac computed tomography based noninvasive assessment of coronary atherosclerotic plaque and stenosis may be useful to improve risk stratification of patients with acute chest pain. Our goal was to determine the diagnostic accuracy of regional LV dysfunction assessed by MDCT for ACS in patients with acute chest pain but normal initial biomarkers and non-ischemic ECG. Methods : We included consecutive subjects without a known history of MI or left ventricular dysfunction who presented to the emergency department (ED) with acute chest pain but had negative initial troponin and no ischemic ECG changes. All subjects underwent standard contrast-enhanced 64-slice cardiac MDCT (0.6mm slice thickness, 120 kVp, 850 mAs) within = hours of presentation. Images were reconstructed at 10% intervals throughout the cardiac cycle and analyzed using short and long axis cine images of the LV cavity created with four-dimensional viewing software. All MDCT scans were assessed qualitatively for regional LV function using the AHA/ACC 17-segment model independently by two experienced readers, who were blinded to the clinical course and coronary plaque and stenosis findings. Results : One-hundred and seventy-three consecutive patients (mean age 56.2 ± 14 years, 56% male) were included. Twenty-two of these patients were ultimately diagnosed with ACS (MI 5, UAP 17) during their index hospitalization. Overall, 23 patients had impaired regional LV function, 17 of them had ACS (MI 5, UAP 12). The specificity (96%) and negative predictive value (96.6 –100%) for detection of ACS was excellent, even when patients with MI or UAP were excluded from subanalysis. Findings are summarized in table 1 . Conclusion: The absence of regional LV dysfunction at rest by MDCT has a excellent specificity for ACS in patients without a known history of CAD who present with acute chest pain of uncertain origin. This information may be complimentary to the detection of coronary plaque and stenosis. Summary of Left Ventricular Function Analysis

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