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首页> 外文期刊>European Heart Journal: The Journal of the European Society of Cardiology >Combined coronary and late-enhanced multidetector-computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast-enhanced cardiac magnetic resonance imaging.
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Combined coronary and late-enhanced multidetector-computed tomography for delineation of the etiology of left ventricular dysfunction: comparison with coronary angiography and contrast-enhanced cardiac magnetic resonance imaging.

机译：结合冠状动脉造影和晚期增强的多探测器计算机断层扫描来描绘左心功能不全的病因：与冠状动脉造影和对比增强的心脏磁共振成像进行比较。

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AIMS: To evaluate whether comprehensive evaluation of coronary anatomy and delayed enhancement (DE) by multidetector-computed tomography (MDCT) would allow determination of etiology of left ventricular dysfunction (LVD) as compared with coronary angiography (CA) and DE-magnetic resonance (CMR). METHODS AND RESULTS: Seventy-one consecutive patients (50 males, 59 +/- 16 years) with LVD (ejection fraction: 26 +/- 11%) of unknown etiology underwent MDCT, LGE (late Gd-DTPA-enhanced)-CMR and CA. Patients were classified into four groups according to coronary artery disease (CAD) by CA and LGE-CMR patterns. Patients (n = 24) with CAD and transmural or sub-endocardial DE by CMR were considered having definite ischaemic LVD (group 1). Patients (n = 36) without CAD by CA and with no/atypical LGE-CMR were considered non-ischaemic LVD (group 2). Further we identified four patients with transmural DE but no CAD (group 3) and seven patients with CAD but no DE (group 4). On per-patient basis, combined coronary and DE-MDCT had excellent agreement (kappa = 0.89; P < 0.001) with CA/LGE-CMR to classify patients into the same four groups. Sensitivity, specificity and accuracy of MDCT were 97, 92 and 94%, respectively for detecting patients with definite (group 1) or likely (groups 3 and 4) ischaemic LVD. CONCLUSION: Combined coronary and DE-MDCT can accurately differentiate ischaemic vs. non-ischaemic etiology of LVD.
机译：目的：为了评估通过多探测器计算机断层扫描（MDCT）对冠状动脉解剖和延迟增强（DE）进行全面评估，是否可以确定与冠状动脉造影（CA）和DE磁共振相比的左心功能不全（LVD）的病因（ CMR）。方法和结果：连续71例（50例男性，59 +/- 16岁）LVD（射血分数：26 +/- 11％）的病因不明的患者接受了MDCT，LGE（晚期Gd-DTPA增强）-CMR和CA。根据CA和LGE-CMR模式​​，根据冠状动脉疾病（CAD）将患者分为四组。患有CAD并经CMR经壁或心内膜下DE的患者（n = 24）被认为具有明确的缺血性LVD（第1组）。没有CA的CAD且无/非典型的LGE-CMR的患者（n = 36）被认为是非缺血性LVD（第2组）。此外，我们确定了4例经壁DE但无CAD的患者（第3组）和7例经CAD但无DE的患者（第4组）。在每位患者的基础上，联合冠状动脉和DE-MDCT与CA / LGE-CMR具有极好的一致性（kappa = 0.89; P <0.001），可以将患者分为相同的四组。 MDCT对确定性（第1组）或可能（第3和第4组）缺血性LVD患者的检测灵敏度，特异性和准确性分别为97％，92％和94％。结论：合并冠脉造影和DE-MDCT可以准确地区分LVD的缺血性和非缺血性病因。

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