Quantitative Assessment of Left Ventricular Function of Coronary Atherosclerotic Heart Disease with 640-Slice Dynamic Volume CT in Comparison to Echocardiography

Objective: The primary aim is to investigate the correlation between 640-slice dynamic volume computer tomography (DVCT) and echocardiography (ECHO) in the function of left ventricular (LV), and the value of DVCT in the evaluation of left coronary artery disease (LCA) and geometry and function of left ventricular, by measuring the difference of left ventricular function of coronary atherosclerotic heart disease with DVCT in comparison to ECHO. Materials and Methods: Sixty-three patients of coronary heart disease (CHD) with left coronary artery disease were selected, all of them were examined by DVCT coronary imaging and ECHO. On the basis of the American Society of Cardiovascular Computed Temography, the study applied the Coronary Artery Disease Report and Data System (CAD-RADS) to assess the left cornary artery. The end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and myocardial mass (MM) of function parameters of the left ventricle were counted. The function parameters of DVCT and ECHO were comparatively analyzed. Results: The results showed that there was a positive correlativity between the value of EDV, ESV, SV and EF which measured through DVCT and the ECHO (r = 0.69, 0.90, 0.60, 0.71 respectively, P < 0.05 all). The differences of ESV, SV, EF between CAD-RADS 2 and 4, CAD-RADS 3 and 4 were significant (P < 0.05). The differences of data of EDV and MM between CAD-RADS 2, 3 and 4 were statistically significant (P < 0.05). Conclusion: Both DVCT coronary artery imaging and ECHO can accurately assess left ventricular function and have a high correlation. DVCT coronary artery imaging can assess CAD and analyze the function of left ventricular. EDV and MM change significantly in CAD-RADS 3, which providing important quantitative data for clinical diagnosis and treatment plan of coronary heart disease.

Cardiac strangulation after epicardial pacing: the importance of non-specific symptoms and a low index of suspicion

Cardiac strangulation is a rare and potentially deadly complication of epicardial pacemaker implantation. A young boy presenting with chest pain and tiredness almost 7 years after pacemaker implantation was found to have cardiac strangulation. Literature review revealed 22 cases reported to date with a worrying rise in the number of reports over the past 3 years. Strangulation is associated with implantation of leads at a young age and appears to be related to somatic growth. Serial assessment with chest X-ray and echocardiogram is recommended, at least until full adult growth is attained with further coronary artery imaging reserved for symptoms or suspicious echocardiographic findings. If cardiac strangulation is diagnosed prompt replacement of the offending system is needed.

Arterial Calcification on Wrist Radiographs May Suggest Need for Evaluation of Atherosclerosis in Asymptomatic Individuals

Asymptomatic individuals with significant coronary artery disease (CAD) are at risk for unanticipated cardiac events including myocardial infarction (MI). Laboratory studies, stress tests, and coronary artery imaging including coronary artery calcium (CAC) scoring evaluate at-risk individuals. Hand and wrist x-rays demonstrating significant arterial wall calcification may provide an additional means to identify asymptomatic individuals at risk for cardiac events. Here we report a case series of patients without known cardiac disease who demonstrated significant calcium deposits in the radial and/or ulnar arteries in radiographs performed for evaluation of their hand conditions. Each series patient was subsequently found to have calcification on coronary artery imaging and an elevated risk of future cardiac events. Our series suggests that peripheral arterial calcifications observed by radiologists and hand specialists may warrant systemic evaluation for atherosclerosis in other areas of the body.