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European Heart Journal Advance Access published online on April 1, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn072
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Non-invasive diagnosis of ischaemic heart failure using 64-slice computed tomography

Saïd Ghostine1,*, Christophe Caussin1, Michel Habis1, Yacoub Habib1, Chaoui Clément1, Anne Sigal-Cinqualbre2, Claude-Yves Angel2, Bernard Lancelin1, André Capderou3 and Jean-François Paul2

1 Department of Cardiology, Marie Lannelongue Hospital, 133 avenue de la Resistance, 92350 Le Plessis Robinson, France
2 Department of Radiology, Marie Lannelongue Hospital, 133 avenue de la Resistance, 92350 Le Plessis Robinson, France
3 CNRS UMR 8162, Université Paris-Sud, Paris, France

Received 1 June 2007; revised 21 December 2007; accepted 1 February 2008.

* Corresponding author. Tel: +33 1 40 94 85 45, Fax: +33 1 40 94 85 49, Email: s.ghostine{at}ccml.fr

Aims: We evaluated the accuracy of 64-slice computed tomography (CT) to identify ischaemic aetiology of heart failure (IHF).

Methods and results: Ninety-three consecutive patients in sinus rhythm with dilated cardiomyopathy but without suspicion of coronary artery disease (CAD) were enrolled when admitted for angiography. Accuracy of CT to detect significant stenosis (>50% lumen narrowing) was compared with quantitative coronary angiography. IHF was defined as a significant stenosis on left main or proximal left anterior descending artery or two or more vessels. Forty-three out of 1395 segments (3%) were heavily calcified and excluded. CT correctly assessed 103 of 142 (73%) significant stenosis and identified 46 of 50 (92%) patients without and 42 of 43 (98%) patients with CAD, 60 of 62 (97%) patients without and 28 of 31 (90%) patients with IHF. Overall, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT for identifying CAD by segment was 96, 73, 99, 92, and 97%, respectively; by patient was 95, 98, 92, 91, and 98%, respectively; and for identifying IHF was 95, 90, 97, 93, and 95%, respectively.

Conclusion: Non-invasive 64-slice CT assessment of the extent of CAD may offer a valid alternative to angiography for the diagnosis of IHF.

Key Words: Cardiomyopathy • Heart failure • Computed tomography • Angiography


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