Skip to main content
Erschienen in: Netherlands Heart Journal 5/2010

01.05.2010 | Interuniversity Cardiology Institute of the Netherlands

Towards a noninvasive anatomical and functional diagnostic work-up of patients with suspected coronary artery disease

verfasst von: J. G. J. Groothuis, A. M. Beek, M. R. Meijerink, S. L. Brinckman, M. B. M. Hofman, A. C. van Rossum

Erschienen in: Netherlands Heart Journal | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Extract

Whereas the diagnostic evaluation of patients with suspected coronary artery disease (CAD) is part of the daily routine of cardiology practice, the conventional modalities for detection of CAD have major limitations. Even though its prognostic value has been validated extensively, exercise electrocardiography only has a limited diagnostic value for detection of significant CAD, with a reported sensitivity and specificity of 68 and 77%, respectively.1 Additionally, in a large proportion of patients results are inconclusive. Although single photon emission computed tomography myocardial perfusion imaging (SPECT) is more sensitive for detection of significant CAD, it only has a moderate specificity.2 Consequently, this leads to a considerable number of unnecessary referrals for invasive coronary angiography. Furthermore, a combined SPECT stress and rest protocol involves a significant radiation burden (10-20 mSv), and requires two separate scanning sessions. …
Literatur
1.
Zurück zum Zitat Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation. 1989;80:87-98. Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation. 1989;80:87-98.
2.
Zurück zum Zitat Kim C, Kwok YS, Heagerty P, Redberg R. Pharmacologic stress testing for coronary disease diagnosis: A meta-analysis. Am Heart J. 2001;142:934-44. Kim C, Kwok YS, Heagerty P, Redberg R. Pharmacologic stress testing for coronary disease diagnosis: A meta-analysis. Am Heart J. 2001;142:934-44.
3.
Zurück zum Zitat Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol. 2007;50:1161-70. Min JK, Shaw LJ, Devereux RB, Okin PM, Weinsaft JW, Russo DJ, et al. Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol. 2007;50:1161-70.
4.
Zurück zum Zitat Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J. 2007;28:3042-50. Abdulla J, Abildstrom SZ, Gotzsche O, Christensen E, Kober L, Torp-Pedersen C. 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis. Eur Heart J. 2007;28:3042-50.
5.
Zurück zum Zitat Henneman MM, Schuijf JD, van Werkhoven JM, Pundziute G, van der Wall EE, Jukema JW,et al. Multi-slice computed tomography coronary angiography for ruling out suspected coronary artery disease: what is the prevalence of a normal study in a general clinical population? Eur Heart J. 2008;29:2006-13. Henneman MM, Schuijf JD, van Werkhoven JM, Pundziute G, van der Wall EE, Jukema JW,et al. Multi-slice computed tomography coronary angiography for ruling out suspected coronary artery disease: what is the prevalence of a normal study in a general clinical population? Eur Heart J. 2008;29:2006-13.
6.
Zurück zum Zitat Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F, et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J. 2006;27:1341-81. Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F, et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J. 2006;27:1341-81.
7.
Zurück zum Zitat Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, et al. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48:1475-97. Hendel RC, Patel MR, Kramer CM, Poon M, Hendel RC, Carr JC, et al. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol. 2006;48:1475-97.
8.
Zurück zum Zitat Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, et al. Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. J Am Coll Cardiol. 2008;52:636-43. Meijboom WB, Van Mieghem CA, van Pelt N, Weustink A, Pugliese F, Mollet NR, et al. Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. J Am Coll Cardiol. 2008;52:636-43.
9.
Zurück zum Zitat Schuijf JD, Wijns W, Jukema JW, Atsma DE, de Roos A, Lamb HJ, et al. Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol. 2006;48:2508-14. Schuijf JD, Wijns W, Jukema JW, Atsma DE, de Roos A, Lamb HJ, et al. Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol. 2006;48:2508-14.
10.
Zurück zum Zitat Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, et al. Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. J Cardiovasc Magn Reson. 2004;6:727-65. Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, et al. Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. J Cardiovasc Magn Reson. 2004;6:727-65.
11.
Zurück zum Zitat Beek AM, Kuhl HP, Bondarenko O, Twisk JW, Hofman MB, van Dockum WG, et al. Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol. 2003;42:895-901. Beek AM, Kuhl HP, Bondarenko O, Twisk JW, Hofman MB, van Dockum WG, et al. Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol. 2003;42:895-901.
12.
Zurück zum Zitat Marcu CB, Nijveldt R, Beek AM, van Rossum AC. Delayed contrast enhancement magnetic resonance imaging for the assessment of cardiac disease. Heart Lung Circ. 2007;16:70-8. Marcu CB, Nijveldt R, Beek AM, van Rossum AC. Delayed contrast enhancement magnetic resonance imaging for the assessment of cardiac disease. Heart Lung Circ. 2007;16:70-8.
13.
Zurück zum Zitat Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, et al. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and quantitative angiography. Circulation. 2001:103:2230-5. Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, et al. Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and quantitative angiography. Circulation. 2001:103:2230-5.
14.
Zurück zum Zitat Kuhl HP, Katoh M, Buhr C, Krombach GA, Hoffmann R, Rassaf T, et al. Comparison of magnetic resonance perfusion imaging versus invasive fractional flow reserve for assessment of the hemodynamic significance of epicardial coronary artery stenosis. Am J Cardiol. 2007;99:1090-5. Kuhl HP, Katoh M, Buhr C, Krombach GA, Hoffmann R, Rassaf T, et al. Comparison of magnetic resonance perfusion imaging versus invasive fractional flow reserve for assessment of the hemodynamic significance of epicardial coronary artery stenosis. Am J Cardiol. 2007;99:1090-5.
15.
Zurück zum Zitat Kurita T, Sakuma H, Onishi K, Ishida M, Kitagawa K, Yamanaka T, et al. Regional myocardial perfusion reserve determined using myocardial perfusion magnetic resonance imaging showed a direct correlation with coronary flow velocity reserve by Doppler flow wire. Eur Heart J. 2009;30:444-52. Kurita T, Sakuma H, Onishi K, Ishida M, Kitagawa K, Yamanaka T, et al. Regional myocardial perfusion reserve determined using myocardial perfusion magnetic resonance imaging showed a direct correlation with coronary flow velocity reserve by Doppler flow wire. Eur Heart J. 2009;30:444-52.
16.
Zurück zum Zitat Schwitter J, Wacker CM, van Rossum AC, Lombardi M, Al-Saadi N, Ahlstrom H, et al. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J. 2008;29:480-9. Schwitter J, Wacker CM, van Rossum AC, Lombardi M, Al-Saadi N, Ahlstrom H, et al. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J. 2008;29:480-9.
17.
Zurück zum Zitat Jahnke C, Nagel E, Gebker R, Kokocinski T, Kelle S, Manka R, et al. Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging. Circulation. 2007;115:1769-76. Jahnke C, Nagel E, Gebker R, Kokocinski T, Kelle S, Manka R, et al. Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging. Circulation. 2007;115:1769-76.
18.
Zurück zum Zitat Pilz G, Jeske A, Klos M, Ali E, Hoefling B, Scheck R, et al. Prognostic value of normal adenosine-stress cardiac magnetic resonance imaging. Am J Cardiol. 2008;101:1408-12. Pilz G, Jeske A, Klos M, Ali E, Hoefling B, Scheck R, et al. Prognostic value of normal adenosine-stress cardiac magnetic resonance imaging. Am J Cardiol. 2008;101:1408-12.
19.
Zurück zum Zitat Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol. 1999;33:2092-197. Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol. 1999;33:2092-197.
20.
Zurück zum Zitat Groothuis JG, Beek AM, Brinckman SL, Meijerink MR, Koestner SC, Nijveldt R, et al. Low to intermediate probability of coronary artery disease: comparison of coronary CT angiography with first-pass MR myocardial perfusion imaging. Radiology. 2010;254:384-92. Groothuis JG, Beek AM, Brinckman SL, Meijerink MR, Koestner SC, Nijveldt R, et al. Low to intermediate probability of coronary artery disease: comparison of coronary CT angiography with first-pass MR myocardial perfusion imaging. Radiology. 2010;254:384-92.
Metadaten
Titel
Towards a noninvasive anatomical and functional diagnostic work-up of patients with suspected coronary artery disease
verfasst von
J. G. J. Groothuis
A. M. Beek
M. R. Meijerink
S. L. Brinckman
M. B. M. Hofman
A. C. van Rossum
Publikationsdatum
01.05.2010
Verlag
Bohn Stafleu van Loghum
Erschienen in
Netherlands Heart Journal / Ausgabe 5/2010
Print ISSN: 1568-5888
Elektronische ISSN: 1876-6250
DOI
https://doi.org/10.1007/BF03091775

Weitere Artikel der Ausgabe 5/2010

Netherlands Heart Journal 5/2010 Zur Ausgabe

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.