This Article Full Text Full Text (PDF) All Versions of this Article: 45/2/227    most recent 01.HYP.0000152201.79955.e4v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schuijf, J. D. Articles by de Roos, A. Search for Related Content PubMed PubMed Citation Articles by Schuijf, J. D. Articles by de Roos, A. Related Collections CT and MRI

(Hypertension. 2005;45:227.)
© 2005 American Heart Association, Inc.

Scientific Contributions

Noninvasive Evaluation of the Coronary Arteries With Multislice Computed Tomography in Hypertensive Patients

Joanne D. Schuijf; Jeroen J. Bax; J. Wouter Jukema; Hildo J. Lamb; Hubert W. Vliegen; Ernst E. van der Wall; Albert de Roos

From the Departments of Cardiology (J.D.S., J.J.B., J.W.J., H.W.V., E.E.v.d.W.) and Radiology (J.D.S., H.J.L., A.d.R.), Leiden University Medical Center, Leiden, the Netherlands; and The Interuniversity Cardiology Institute of the Netherlands (J.D.S., J.W.J., E.E.v.d.W.), Utrecht, the Netherlands.

Correspondence to J.J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2,2333 ZA Leiden, the Netherlands. E-mail jbax{at}knoware.nl

Because patients with hypertension are at increased risk for coronary artery disease, early and noninvasive identification of the disease in patients with hypertension is important. Recently, multislice computed tomography (MSCT) has been demonstrated to allow both noninvasive coronary angiography and assessment of left ventricular function. The purpose of the present study therefore was to demonstrate the feasibility of this approach in patients with hypertension with known or suspected coronary artery disease and to compare the results to invasive coronary angiography and 2-dimensional echocardiography, respectively. MSCT was performed in 31 patients with confirmed hypertension. From the MSCT images, the presence of significant coronary stenoses (50% luminal narrowing) and regional wall motion abnormalities were evaluated and compared with invasive coronary angiography and 2-dimensional echocardiography. In addition, left ventricular ejection fraction was calculated from the MSCT images. A total of 243 (88%) coronary artery segments could be evaluated with MSCT. Sensitivity and specificity for the detection of significant coronary artery stenoses were 93% and 96%. On a per-patient basis, MSCT was accurate in 28 (90%) patients. Mean left ventricular ejection fraction was 46±14% (range, 16% to 64%). The agreement for assessing regional wall motion was 91% (kappa statistic, 0.81). In conclusion, simultaneous, noninvasive evaluation of coronary artery stenoses and left ventricular function with MSCT is accurate in patients with hypertension. This noninvasive approach may allow triage of patient treatment in terms of conservative versus invasive management.

Key Words: coronary artery disease • imaging

This article has been cited by other articles:

				P. K. Vanhoenacker, M. H. Heijenbrok-Kal, R. Van Heste, I. Decramer, L. R. Van Hoe, W. Wijns, and M. G. M. Hunink Diagnostic Performance of Multidetector CT Angiography for Assessment of Coronary Artery Disease: Meta-analysis Radiology, August 1, 2007; 244(2): 419 - 428. [Abstract] [Full Text] [PDF]

				J. M Schussler and P. A Grayburn Non-invasive coronary angiography using multislice computed tomography Heart, March 1, 2007; 93(3): 290 - 297. [Abstract] [Full Text] [PDF]

				H. Dogan, L. J. M. Kroft, J. J. Bax, J. D. Schuijf, R. J. van der Geest, J. Doornbos, and A. de Roos MDCT Assessment of Right Ventricular Systolic Function Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S366 - S370. [Abstract] [Full Text] [PDF]

				A de Roos, L J M Kroft, J J Bax, H J Lamb, and J Geleijns Cardiac applications of multislice computed tomography Br. J. Radiol., January 1, 2006; 79(937): 9 - 16. [Abstract] [Full Text] [PDF]