Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner.
Alexisz PanajotuMilán Vecsey-NagyÁdám Levente JermendyMelinda BoussoussouBorbála VattayMarton KolossvaryÖrs Zs DombrádyCsaba Csobay-NovákBéla MerkelyBálint SzilveszterPublished in: Diagnostics (Basel, Switzerland) (2023)
There has been an ongoing debate on the means to minimize the time patients spend at health care providers during the COVID-19 pandemic. We propose a strategy relying solely on intravenous (i.v.) beta-blocker administration for heart-rate (HR) control prior to coronary CT angiography (CCTA). We aimed to assess a potential difference in CCTA image quality (IQ) after implementation of a modified strategy compared to our standard protocol of oral premedication during the first wave of COVID-19. We analyzed CCTA examinations conducted one year before ( n = 1511) and after ( n = 1064) implementation of this new regime. Examinations were performed both on our 256-slice multidetector CT (MDCT) and dedicated cardiac CT (DCCT) scanners. We used a four-point Likert scale (excellent/good/moderate/non-diagnostic) for IQ assessment of the coronaries. We detected a significant increase in mean HR during examinations on both CT scanners (MDCT: 62.4 ± 10.0 vs. 65.3 ± 9.7, p < 0.001; DCCT: 61.7 ± 15.2 vs. 65.0 ± 10.7, p < 0.001). The rate of moderate/non-diagnostic IQ significantly increased on the MDCT (192/1005, 19.1% vs. 144/466, 30.9%, p < 0.001), while this ratio did not change significantly on the DCCT (62/506, 12.3% vs. 84/598, 14.0%, p = 0.38). The improved temporal resolution of DCCT allows the stand-alone use of i.v. premedication with preserved IQ; hence, the duration of visits can be shortened.
Keyphrases
- image quality
- computed tomography
- heart rate
- healthcare
- dual energy
- coronary artery disease
- randomized controlled trial
- coronary artery
- primary care
- heart rate variability
- blood pressure
- ejection fraction
- coronavirus disease
- left ventricular
- high intensity
- sars cov
- newly diagnosed
- quality improvement
- magnetic resonance imaging
- positron emission tomography
- aortic stenosis
- magnetic resonance
- risk assessment
- patient reported outcomes
- chronic kidney disease
- single molecule
- low dose
- human health
- pet ct
- health insurance