Simultaneous Viability Assessment and Invasive Coronary Angiography Using a Therapeutic CT System in Chronic Myocardial Infarction Patients

In a preclinical study using a swine myocardial infarction (MI) model, a delayed enhancement (DE)-multi-detector computed tomography (MDCT) scan was performed using a hybrid system alongside diagnostic invasive coronary angiography (ICA) without the additional use of a contrast agent, and demonstrat...

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Published inYonsei medical journal Vol. 65; no. 5; pp. 257 - 264
Main Authors Ha, Seongmin, Jang, Yeonggul, Lee, Byoung Kwon, Hong, Youngtaek, Kim, Byeong-Keuk, Park, Seil, Yoo, Sun Kook, Chang, Hyuk-Jae
Format Journal Article
LanguageEnglish
Published Korea (South) Yonsei University College of Medicine 01.05.2024
연세대학교의과대학
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ISSN0513-5796
1976-2437
1976-2437
DOI10.3349/ymj.2023.0208

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Summary:In a preclinical study using a swine myocardial infarction (MI) model, a delayed enhancement (DE)-multi-detector computed tomography (MDCT) scan was performed using a hybrid system alongside diagnostic invasive coronary angiography (ICA) without the additional use of a contrast agent, and demonstrated an excellent correlation in the infarct area compared with histopathologic specimens. In the present investigation, we evaluated the feasibility and diagnostic accuracy of a myocardial viability assessment by DE-MDCT using a hybrid system comprising ICA and MDCT alongside diagnostic ICA without the additional use of a contrast agent. We prospectively enrolled 13 patients (median age: 67 years) with a previous MI (>6 months) scheduled to undergo ICA. All patients underwent cardiac magnetic resonance (CMR) imaging before diagnostic ICA. MDCT viability scans were performed concurrently with diagnostic ICA without the use of additional contrast. The total myocardial scar volume per patient and average transmurality per myocardial segment measured by DE-MDCT were compared with those from DE-CMR. The DE volume measured by MDCT showed an excellent correlation with the volume measured by CMR (r=0.986, <0.0001). The transmurality per segment by MDCT was well-correlated with CMR (r=0.900, <0.0001); the diagnostic performance of MDCT in differentiating non-viable from viable myocardium using a 50% transmurality criterion was good with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 87.5%, 99.5%, 87.5%, 99.5%, and 99.1%, respectively. The feasibility of the DE-MDCT viability assessment acquired simultaneously with conventional ICA was proven in patients with chronic MI using DE-CMR as the reference standard.
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Seongmin Ha and Yeonggul Jang contributed equally to this work.
https://www.eymj.org/DOIx.php?id=10.3349/ymj.2023.0208
ISSN:0513-5796
1976-2437
1976-2437
DOI:10.3349/ymj.2023.0208