Systolic reconstruction in patients with low heart rate using coronary dual-source CT angiography

• Published in: European journal of radiology 2011-11, Vol.80 (2), p.336-341
• Main Authors: Okada, Munemasa, Nakashima, Yoshiteru, Shigemoto, Youko, Matsunaga, Naofumi, Miura, Toshiro, Nao, Tomoko, Sano, Yuichi, Narazaki, Akiko, Kido, Shoji
• Format: Article
• Language: English
• Subjects: Aged; Algorithms; Biological and medical sciences; Bradycardia - diagnostic imaging; Bradycardia - physiopathology; Cardiology. Vascular system; Cardiovascular system; Coronary Angiography - methods; Coronary CT angiography; Coronary Disease - physiopathology; Diabetes Mellitus - physiopathology; Dual-source CT; Female; Heart; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Rate - physiology; Humans; Hypertension - physiopathology; Investigative techniques, diagnostic techniques (general aspects); Left ventricular diastolic dysfunction; Male; Medical sciences; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiographic Image Interpretation, Computer-Assisted - methods; Radiology; Risk Factors; Systole; Systolic reconstruction; Tomography, X-Ray Computed - methods; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2011.01.104

Abstract Objectives The purpose of our study was to determine the relationship between the predictive factors and systolic reconstruction (SR) as an optimal reconstruction window in patients with low heart rate (LHR; less than 65 bpm). Methods 391 patients (262 male and 129 female, mean age; 67.1 ± 10.1 years of age) underwent coronary CTA without the additional administration of a beta-blocker. Affecting factors for SR were analyzed in age, gender, body weight (BW), diabetes mellitus (DM), coronary arterial disease (CAD), ejection fraction (EF), systolic and diastolic body pressure (BP) and heart rate variability (HRV) during coronary CTA. Results In 29 (7.4%) of the 391 patients, SR was needed, but there was no apparent characteristic difference between the systolic and diastolic reconstruction groups in terms of gender, age, BW, DM, CAD and EF. In a multivariate analysis, the co-existence of DM [ P < 0.05; OR, 0.27; 95% CI, 0.092–0.80], diastolic BP [ P < 0.01; OR, 0.95; 95% CI, 0.92–0.98] and HRV [ P < 0.01; OR, 0.98; 95% CI, 0.96–0.99] were found to be the factors for SR. In gender-related analysis, HRV was an important factor regardless of sex, but co-existence of DM affected especially for female and BP for male. Conclusion Especially in the patients with LHR who had a medication of DM, high HRV or high BP, SR, in addition to DR, was needed to obtain high-quality coronary CTA images.