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Detection of significant coronary artery stenosis with 64-slice computed tomography in heart transplant recipients: a comparative study with conventional coronary angiography

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Abstract

Purpose The present study evaluates clinical feasibility of cardiac multidetector computed tomography angiography (MDCTA) to detect significant stenosis of coronary vessels due to transplant vasculopathy (TVP) after heart transplantation (HTx). Methods Twenty-eight consecutive male HTx-recipients scheduled for their annual routine conventional coronary angiography (CCA) additionally underwent 64-slice MDCTA. Results Two patients were excluded from further MDCTA analysis. Out of 371 remaining coronary vessel segments evaluable by CCA, MDCTA was able to depict 302 (81.4%) in diagnostic image quality. On a segment based analysis, sensitivity, specificity, diagnostic accuracy (DA), negative predictive value (NPV), and positive predictive value (PPV) for detection of significant stenosis were calculated with 87.5%, 97.3%, 97.0%, 99.7%, and 46.7%, respectively. On a patient-based evaluation, sensitivity, specificity, DA, NPV, PPV were 100%, 81%, 84.6%, 100% and 55.6%, respectively. Evaluation of stenosis degree by MDCTA showed systematic overestimation of 4.4%. A moderate to good agreement comparing both modalities was found (Pearson’s correlation coefficient: 0.64). Conclusion High NPV suggesting 64-slice MDCTA being a reliable diagnostic tool for ruling out significant stenosis due to TVP in HTx patients. But its clinical value in these particular patients needs further investigation.

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Authors and Affiliations

  1. Department of Cardiology, Ludwig-Maximilians-University, Grosshadern Campus, Munich, Germany

    Franz von Ziegler, Alexander W. Leber, Alexander Becker, Ulf Schönermarck, Janine Tittus, Gerhard Steinbeck & Andreas Knez

  2. University of Munich, Klinikum Grosshadern, Medizinische Klinik I, Marchioninistraße 15, 81377, Munchen, Germany

    Franz von Ziegler

  3. Department of Cardiac Surgery, Ludwig-Maximilians-University, Grosshadern Campus, Munich, Germany

    Ingo Kaczmarek, Christine Raps & Peter Überfuhr

  4. Department of Clinical Radiology, Ludwig-Maximilians-University, Grosshadern Campus, Munich, Germany

    Christoph R. Becker & Maximilian Reiser

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  1. Franz von Ziegler
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  2. Alexander W. Leber
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  3. Alexander Becker
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  4. Ingo Kaczmarek
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  5. Ulf Schönermarck
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  11. Gerhard Steinbeck
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  12. Andreas Knez
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Correspondence to Franz von Ziegler.

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von Ziegler, F., Leber, A.W., Becker, A. et al. Detection of significant coronary artery stenosis with 64-slice computed tomography in heart transplant recipients: a comparative study with conventional coronary angiography. Int J Cardiovasc Imaging 25, 91–100 (2009). https://doi.org/10.1007/s10554-008-9343-z

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  • DOI: https://doi.org/10.1007/s10554-008-9343-z

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