Characterization of coronary Artery Diseases using 256 multi

Abstract

Coronary heart disease is the most common cause of death in the general population. Multi detector ComputedTomography (MDCT) is noninvasive technique and can study the entire coronary-artery tree during a single imaging session. The aims of this study were to characterize coronary arteries in patients who were clinically diagnosed to have coronary arterydisease (CAD) using (MDCT) 256 slices, and to compare the findings with other cardiac examinations outcome. The study wasdone at King Fahad Specialist Hospital-Alqaseem- KSA during the period from January to May 2013 .A total of 102 patients, 63 (61.76%)males, and 39 (38.24 %) females were included. All patients with pre-test probability of CAD underwent coronaryCT angiography with beta-blockers were administered prior to the scan, and other cardiac investigations were obtained. Patient’sage, gender, BMI, weight, Cholesterol level, Hypertension, Diabetes Mellitus, chest pain types, Calcium scoring, were evaluatedand correlated with the CT findings and other cardiac investigation results. The evaluated arteries were Left Main Artery (LMA), Left Anterior Descending artery (LAD), Right Coronary Artery (RCA), and Left Circumference Artery (LCA) and wereobserved for plaques characterization, occlusion or stenosis. A significant association was detected between the CT plaquesmorphology and BMI, Hypertension and calcium score at P-value < 0.05. Patients with normal findings in ECG 53 (57.6%),Echocardiography 58.0(76.3%) and Myocardial Perfusion Imaging (MPI) 2(25.0%) were found to have positive cardiac diseasein CTA. Echocardiography is able to characterize Atrial filibration, Heart failure, Ventricle diseases, Valve stenosis and hassignificant association with gender P-value 0.022 and BMI P-value 0.042.Myocardial Perfusion Imaging results showed thecardiac function and ejection fraction. No significant association was found between CT findings in coronary arteries and MPIresults at P-value 0.789.Coronary CTA disclose diseases in arteries (98.5%), heart anomalies or valve disease 3(3%) ,plaques with significant stenosis 4(4%) , plaque without significant stenosis 11(10.9%) ,stenosis without plaques 14 (14%) and totalocclusion 1(1%). In relation to other cardiac tests; cardiac ischemic changes can be detected in ECG, MPI and Echocardiography. Association between CT Plaque Characteristics and Invasive Coronary Arteries results were significant for LAD and RCA atP-value 0.05. Coronary CTA is a promising non-invasive technique and is highly recommended for characterization of CoronaryArteries and diagnosis the CAD; it could be of great value prior to invasive coronary angiography, although ECG, Echocardiography and MPI(SPECT) are better in studying function.

Keywords: 256 MDCT, Coronary Arteries Diseases, Cardiac Imaging