Ternovoy Sergey, Ustyuzhanin Dmitry, Shariya Merab, Shabanova Maria, Gaman Svetlana, Serova Natalya, Mironov Vsevolod, Merkulova Irina, Rienmueller Anna, Meyer Elias Laurin, Rienmueler Theresa
Sechenov First Moscow State Medical University (Sechenov University), 6-1 Bolshaya Pirogovskaya st., 119435 Moscow, Russian Federation.
National Medical Research Center of Cardiology, 15а 3-rd Cherepkovskaya st., 121552, Moscow, Russian Federation.
Heliyon. 2021 Feb 1;7(2):e06075. doi: 10.1016/j.heliyon.2021.e06075. eCollection 2021 Feb.
Cardiovascular computed tomography (cardiovascular CT) is currently used as a fast non-invasive method for the visualization of coronary plaques and walls and the assessment of lumen stenosis severity. Previous studies demonstrated the high negative predictive value of CT for the exclusion of coronary lumen stenoses. In this study we hypothesize that coronary CT angiography (CTA) represents a reliable method as diagnostic procedure in acute coronary syndrome (ACS) even in emergency settings.
36 patients (51 lesions) with ACS who underwent cardiovascular CT, intravascular ultrasound (IVUS) and invasive coronary angiography (ICA) within 48 h were included. The percentage of coronary stenoses were measured and compared by three methods. Influence of available predictors that can potentially affect the measurement results was assessed.
Cardiac CTA provided comparable results to IVUS (mean difference -0.45%, PPV: 98%, NPV: 75%). ICA tends to estimate lower stenoses degrees than cardiac CTA and IVUS (mean difference 13.19% and 13.64%, respectively). The final diagnosis and positive remodeling did not lead to any significant influence on measurements.
The cardiovascular CT results show that even in emergency settings it is possible to identify morphological changes as sequels of coronary artery sclerosis with comparable results to the reference method IVUS. Deviations of IVUS and cardiovascular CT from ICA are comparable and can to a large extent be explained by differences in the measurement technique.
心血管计算机断层扫描（心血管CT）目前作为一种快速无创的方法，用于观察冠状动脉斑块、血管壁以及评估管腔狭窄的严重程度。既往研究表明，CT对于排除冠状动脉管腔狭窄具有较高的阴性预测价值。在本研究中，我们假设即使在急诊情况下，冠状动脉CT血管造影（CTA）在急性冠状动脉综合征（ACS）的诊断过程中也是一种可靠的方法。
纳入36例（51处病变）在48小时内接受心血管CT、血管内超声（IVUS）和有创冠状动脉造影（ICA）检查的ACS患者。采用三种方法测量并比较冠状动脉狭窄的百分比。评估了可能影响测量结果的现有预测因素的影响。
心脏CTA与IVUS的结果相当（平均差异-0.45%，阳性预测值：98%，阴性预测值：75%）。ICA倾向于比心脏CTA和IVUS估计更低的狭窄程度（平均差异分别为13.19%和13.64%）。最终诊断和阳性重塑对测量结果没有显著影响。
心血管CT结果表明，即使在急诊情况下，也能够识别冠状动脉硬化后遗症的形态学变化，其结果与参考方法IVUS相当。IVUS和心血管CT与ICA的偏差相当，并且在很大程度上可以由测量技术的差异来解释。
