scholarly journals Quantitative Evaluation of Coronary Plaque Progression by Computed Tomographic Angiography

2017 ◽  
Vol 44 (5) ◽  
pp. 312-319
Author(s):  
Xiujian Liu ◽  
Guanghui Wu ◽  
Chuangye Xu ◽  
Yuna He ◽  
Lixia Shu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Computed Tomographic Angiography ◽  
Plaque Burden ◽  
Plaque Volume ◽  
Computed Tomographic ◽  
Luminal Area ◽  
The Right ◽  
Tomographic Angiography

Understanding plaque formation in patients at risk for coronary artery disease—the leading cause of morbidity and death in the world—enables physicians to better determine whether and how to treat these individuals. We used computed tomographic angiography to quantitatively evaluate the progression of nonculprit coronary plaques along the full length of the right coronary artery in 21 patients with acute coronary syndrome. Each right coronary artery was analyzed in sequential, 3-mm-long segments, and the minimum luminal area, plaque burden, and plaque volume within each segment were evaluated at baseline and at 12-month follow-up. Serial remodeling of the right coronary artery was also evaluated. In total, 625 arterial segments were analyzed. At 12-month follow-up, the plaque burden had increased slightly by 0.34% (interquartile range [IQR], −4.32% to 6.35%; P=0.02), and the plaque volume was not significantly changed (0.33 mm3; IQR, −3.05 to 3.54; P=0.213). The minimum luminal area decreased 0.05 mm2 (IQR, −1.33 to 0.87 mm2; P=0.012), and this was accompanied by vessel reduction, as evidenced by negative remodeling in 43% of the 625 segments. We conclude that serial computed tomographic angiography can be used to quantitatively evaluate the morphologic progression of coronary plaques.

P6149Coronary computed tomographic angiography (CTA) for risk stratification in the diagnostic triage of patients undergoing liver transplantation (LT): A long-term outcome study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Strobl ◽  
T Senoner ◽  
A Finkenstedt ◽  
G Widmann ◽  
F Plank ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Calcium Score ◽  
Computed Tomographic Angiography ◽  
Plaque Burden ◽  
Computed Tomographic ◽  
All Cause Mortality ◽  
Stenosis Severity ◽  
Tomographic Angiography

Abstract Background Cardiovascular (CV) risk stratification in patients with end-stage liver disease (ESLD) prior to liver transplantation (LT) is crucial: CV-disease poses a major threat for posttransplant survival. Therefore, our purpose was to assess safety of coronary computed tomographic angiography (CTA) in patients prior to orthotopic LT over a long-term follow up period, and its value for CV risk stratification. Methods In this single center, retrospective observational study 458 patients underwent coronary calcium score (CCS) and coronary CTA for pre-LT risk stratification between 2005 and 2016. CTA was evaluated for 1) stenosis severity (CADRADS: 4-severe>70%/3-intermediate50–70%/2-mild<50%/1-minimal<25%/0=no CAD) 2) plaque burden (SIS, G-score), 3) high–risk plaque features (Napkin Ring Sign, low attenuation plaque, positive remodelling) and 4) Coronary Calcium Score. Primary endpoint was mortality (all-cause and cardiovascular), secondary endpoint major cardiovascular events (MACE). Results Finally 270 patients (79.3% males, age 61±8.5 years) who underwent orthotopic LT were included (mean follow-up 7.5 years±3.1, range 2–13). 87 (32.2%) had CCS zero and 60 (22.2%) CCS >300 Agatston Units (CCS 335.6 AU± 868.9). 248 patients underwent CTA after CCS. The majority had CAD (n=173, 72.3%) by CTA while only 75 (27.7%) had no CAD. 102 patients (38.8%) had minimal-or-mild stenosis<50% (CADRADS 1–2), 34 (12.9%) intermediate and 17 (6.5%) severe stenosis.Out of CCS 0 patients, 13 had non-calcified plaque. All-cause mortality rate was 46 (17.0%), with the majority of patients (43 (93.5%) experiencing non-cardiac death and 3 (6.5%) cardiovascular death due to 1 myocardial infarction and 2 cardiopulmonary failure. CADRADS predicted mortality (Kaplan Meir, p<0.001). On multivariate Cox Regression modell, SIS and G-score predicted all-cause mortality (HR 1.1:p=0.034; 95% CI: 0.649–0.983 and HR 1.1, p=0.029; 95% CI: 1.0–1.6), while Calcium Score did not. There were 6 MACE (3 STEMI, 3 NSTEMI). MACE rate was 0% in CADRADS 0 or 1, 1 in CADRADS-2 and increasing to 5 in CADRADS 3 and 4 groups. Coronary CTA for LT risk stratification Conclusion Cardiac CT is a reliable non-invasive modality for pre-LT assessment of CV-risk over a long-term period, with 0% MACE in patients with no CAD or minimal CAD. CTA allows for an improved CV-risk stratification by stenosis severity (CADRADS) and plaque burden as compared to calcium scoring.

Cardiovascular Computed Tomographic Angiography as a Virtual Patient Avatar for Individualized Surgical Planning of Complex Anomalous Coronary Artery Anatomy

2019 ◽  
Vol 10 (4) ◽  
pp. 502-503
Author(s):  
Jerold S. Shinbane ◽  
Craig Baker ◽  
Farhood Saremi ◽  
Vaughn Starnes
Keyword(s):  
Coronary Artery ◽  
Computed Tomographic Angiography ◽  
Virtual Patient ◽  
Single Coronary Artery ◽  
Anomalous Coronary Artery ◽  
Computed Tomographic ◽  
Coronary Artery Anatomy ◽  
The Right ◽  
Tomographic Angiography ◽  
Anomalous Coronary

Cardiovascular computed tomographic angiography (CCTA) 3-D thoracic reconstruction can serve as a “virtual patient avatar” providing surgical views for approach to complex anomalous coronary artery anatomy. Images demonstrated a single coronary artery ostium arising from the right aortic sinus with trifurcation into a prepulmonic left anterior descending coronary artery (LAD), an interarterial circumflex with a subsequent intraseptal course, and normal course of the right coronary artery. Virtual 3-D CCTA reconstructions were important to planning an incisional plane for surgical correction.

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