The Influence of Heart Rate and Coronary Calcification on the Diagnostic Accuracy of 64-slice Multidetector Cardiac CT in Coronary Artery Disease

Epidemiological studies have observed East Asians (EAs) are significantly less likely to develop or die from coronary artery disease (CAD) compared with Caucasians. Conversely South Asians (SAs) develop CAD at higher rate and earlier age. Recently, a range of features derived from cardiac CT have been identified which may further characterise ethnic differences in CAD. Emerging data suggest EAs exhibit less coronary calcification and high-risk, non-calcified plaque compared with Caucasians on CT, with no difference in luminal stenosis. In contrast, SAs exhibit similar to higher coronary calcification and luminal stenosis, smaller luminal dimensions and more high-risk, non-calcified plaque than Caucasians. Beyond demonstrating ethnic differences in CAD, cardiac CT may enhance and individualise cardiovascular risk stratification in EAs and SAs. While data thus far in EAs have demonstrated calcium score and CT-derived luminal stenosis may incrementally predict cardiovascular risk beyond traditional risk scores, there remains a paucity of data assessing its use in SAs. Future studies may clarify the prognostic value of cardiac CT in SAs and investigate how this modality may guide preventative therapy and coronary intervention of CAD in EAs and SAs.

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Chronomes (rhythms, chaos and age and disease trends) of heart rate variability (HRV) in patients with coronary artery disease (CAD)

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1016/s1053-0770(98)90287-7 ◽

1998 ◽

Vol 31 ◽

pp. 46

Author(s):

K OTSUKA

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Coronary Artery ◽

Artery Disease

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2063 Heart-rate variability reflects the severity of coronary artery disease

European Heart Journal ◽

10.1016/s0195-668x(03)95057-3 ◽

2003 ◽

Vol 24 (5) ◽

pp. 381

Author(s):

O MANFRINI

Keyword(s):

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Coronary Artery ◽

Artery Disease

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Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

Clinical Medicine Insights Cardiology ◽

10.4137/cmc.s3864 ◽

2010 ◽

Vol 4 ◽

pp. CMC.S3864 ◽

Cited By ~ 3

Author(s):

M. Wehrschuetz ◽

E. Wehrschuetz ◽

H. Schuchlenz ◽

G. Schaffler

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Diagnostic Potential ◽

Coronary Artery Stenoses ◽

Artery Disease ◽

Msct Angiography

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.

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The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease

Diabetes and Vascular Disease Research ◽

10.1177/14791641211020184 ◽

2021 ◽

Vol 18 (3) ◽

pp. 147916412110201

Author(s):

Katarzyna Szmigielska ◽

Anna Jegier

Keyword(s):

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Heart Rate ◽

Heart Rate Variability ◽

Coronary Artery ◽

Cardiac Rehabilitation ◽

Interval Training ◽

Patients With Diabetes ◽

Artery Disease

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes. Method: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. Results: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. Conclusions: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.

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