Myocardial Stress Perfusion Imaging With Dual Source CT

Massachusetts General Hospital50 enrolled

Overview

The investigators propose a novel technique using dual source multidetector computed tomography (DSCT) where information on both coronary anatomy and myocardial perfusion is obtained in a single scan. The investigators hypothesize that a coronary CTA protocol can be devised to obtain resting myocardial perfusion, myocardial perfusion after stress, and coronary anatomy. Hence, one diagnostic test will be able to detect the presence of coronary plaque as well as assess the functional significance of a stenosis.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Coronary Artery Disease

Interventions

Adenosine Stress Dual-source CTPOTHER

Adenosine- continuous infusion at 140mcg/ kg/ min for 2.5 min; Iopamidol (IV contrast)- total dose of 150cc; Siemens SOMATOM Definition CT scanner (CT scan radiation) - effective radiation dose of approximately 13mSv (tube voltage 120kV, tube current 340mAs for one retrospectively gated cardiac CT with tube current modulation and two prospectively gated cardiac CTs on a Dual Source scanner) This is an observational trial, and all patients will undergo the Adenosine Stress Dual-source CTP procedure.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * A prior adenosine or exercise stress SPECT exam with high likelihood of being referred to the cardiac catheterization laboratory for invasive angiogram * Age \> 40 years old * Able to comprehend and sign the consent form. Exclusion Criteria: * Acute coronary syndromes (unstable angina, non-ST elevation myocardial infarction, ST elevation myocardial infarction) * Unstable clinical conditions (i.e. hemodynamic instability, arrhythmias) * Premenopausal women who have a positive pregnancy test. * Serum Creatinine level ≥1.5 mg/dl as an indicator of renal insufficiency. * Known allergy to iodinated contrast agents * Atrial fibrillation * Asthma * Critical aortic stenosis * Systolic blood pressure \< 90 mmHg * Advanced heart block

Locations (1)

Massachusetts General Hospital

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

Per-Vessel Sensitivity of CTP in the Detection of Myocardial Perfusion Defects During Pharmacological Stress as Compared to Invasive Angiography.

The gold standard for abnormality by CTP is defined as a focal stenosis of \>50% at quantitative analysis of invasive coronary angiography images, when performed.

Time frame: 18 months

Per-Vessel Specificity of CTP in the Detection of Myocardial Perfusion Defects During Pharmacological Stress as Compared to Invasive Angiography.

The gold standard for abnormality by CTP is defined as stenosis of 50% or more at quantitative analysis of invasive coronary angiography images, when performed.

Time frame: 18 months

Secondary Outcomes

Per-Patient Correlation Between CTP and SPECT at Stress.

Pearson Correlation between research interpretation of CTP images and SPECT images, both performed during stress.

Time frame: 18 months

Per-Patient Correlation Between CTP and SPECT at Rest.

Pearson Correlation performed on myocardial abnormalities on CTP and SPECT images, obtained at rest.

Time frame: 18 months

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.