Diagnostic accuracy of dual-source CT coronary angiography with prospective electrocardiography-triggering in patients with higher heart rate

Objective: To evaluate the diagnostic accuracy of dual-source CT (DSCT) prospective ECG-triggering coronary angiography in patients with different heart rate (HR). Methods: One hundred and three patients with suspected coronary artery disease underwent DSCT prospective ECG-triggered coronary angiography and invasive coronary angiography (ICA). The patients were grouped by HR during CT scans: low HR (< 60 bpm, n=34) , medium HR (60-70 bpm, n=36) and high HR (> 70 bpm, n= 33). Image quality was scored using a 4-point scale. The sensitivity and specificity of DSCT in detecting ? 50% stenosis were compared among subgroups where ICA was the gold standard. The differences were compared by using the χ2 test of contingency on a per-segment and per-vessel basis. Results: Image quality of 1580 coronary artery segments m 1648 (95.9%) met the requirements for diagnosis. The image quality scores were (3.1±0.3), (3.1±0.3) and (3.0±0.4) point for subgroups (χ2=2.80, P>0.05). Sensitivity and specificity were 82.8% (77/93) and 98.4% (428/435), 88.3% (91/103) and 98.7% (442/448), and 80.3% (57/71) and 98.6% (424/430) for different subgroups (χ2 were 0.69 and 0.13, all P>0.05). The overall area under the receiver operating characteristic (ROC) curve was 0.94 (95% CI=0.92-0.96). The average effective radiation dose was (3.60±1.60) mSv. Conclusion: DSCT coronary angiography with prospective ECG-triggering could be used for patients with high HR. And the diagnostic accuracy was not statistical significant between the patients with low HR and patients with medium to high HR. (authors)