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Titolo:
Importance of ECC-triggering for ruling out coronary calcification with the multi-slice-CT in individuals asymptomatic for ischemic CAD: Data from the MUNICH-Registry
Autore:
Silber, S;
Indirizzi:
Herzdiagnost Zentrum Hdz, Munich, Germany Herzdiagnost Zentrum Hdz Munich Germany st Zentrum Hdz, Munich, Germany
Titolo Testata:
HERZ
fascicolo: 4, volume: 26, anno: 2001,
pagine: 260 - 272
SICI:
0340-9937(200106)26:4<260:IOEFRO>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
GER
Soggetto:
BEAM COMPUTED-TOMOGRAPHY; ACUTE MYOCARDIAL-INFARCTION; AMERICAN-HEART-ASSOCIATION; INTIMA-MEDIA THICKNESS; ELECTRON-BEAM; ARTERY DISEASE; CARDIOVASCULAR RISK; FOLLOW-UP; INTRACORONARY ULTRASOUND; HEALTH-PROFESSIONALS;
Keywords:
multi-slice-CT; EBT; ECG-triggering; coronary calcification; calcium score; agatston score;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
110
Recensione:
Indirizzi per estratti:
Indirizzo: Silber, S Herzdiagnost Zentrum Hdz, Munich, Germany Herzdiagnost Zentrum Hdz Munich Germany Hdz, Munich, Germany
Citazione:
S. Silber, "Importance of ECC-triggering for ruling out coronary calcification with the multi-slice-CT in individuals asymptomatic for ischemic CAD: Data from the MUNICH-Registry", HERZ, 26(4), 2001, pp. 260-272

Abstract

Background: To avoid unnecessary cardiac catheterization, ruling out coronary calcification has become increasingly important. On the other hand, thedetection of coronary calcification is proof of coronary atherosclerosis and therefore requires a reduction of the LDL-cholesterol < 100 mg/ml according to the NCEP guidelines. The "gold standard" for calcium scanning is traditionally EGG-triggered electron beam tomography (EBT). In addition, mechanical multi-slice CTs (MSCT) have been used without EGG-triggering for morethan 6 years for calcium scanning. Patients and Methods: The importance of ECG-triggering was assessed by examining apparently healthy subjects referred by their physicians (n = 1,206,57 +/- 10 years, 75% male) using an Mx-8000 four-slice CT (Marconi, USA). Data were obtained from the MUNICH-Registry (MUltislice Normal Incidence of Coronary Health). Image acquisition without ECC-triggering was performed inspiral mode at 120 kV and 249 mAs using a collimation of 2.5 mm, resultingin an effective slice width of 3.2 mm. Prospective EGG-triggering was achieved in sequential ("axial") mode at 120 kV and 165 mAs using an effective collimation of 2.5 mm. The trigger was set at 333 ms prior to 90% of the expected PR-interval. Results: With both groups well comparable regarding age, sex and risk factors, calcium was ruled our in 51.5% of the individuals without a nd in 34% of the persons with ECG-triggering (p < 0.007). An Agatston score > 100 wasdetected in 14.2% without and in 33.1% with EGG-trigger. The log(e)-transformed calcium scores were 1.7 +/- 2.2 for persons without and 2.9 +/- 2.6 with EGG-trigger (p < 0.001). Multivariate linear regression analysis showedthat the application of EGG-triggering was an independent and the strongest predictor for the proof of calcium. With EGG-triggering, calcium was detected in 1.51 +/- 1.42 major coronary arteries (median 1.0), whereas withoutECC-triggering, calcium was detected in 1.03 +/- 1.33 major coronary arteries (median 0.0, p < 0.001). Conclusion: Since without ECG-triggering every fifth patient with coronaryatherosclerosis is erroneously classified as "healthy" and only the sensitive exclusion of coronary calcium is helpful in avoiding unnecessary cardiac catheterizations, the use of ECG-triggering for calcium scanning with MSCT is mandatory.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 20:13:59