Journal of cardiovascular computed tomography

Publisher: Elsevier

Current impact factor: 2.29

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.289
2013 Impact Factor 4.506
2012 Impact Factor 2.552

Impact factor over time

Impact factor
Year

Additional details

5-year impact 0.00
Cited half-life 3.60
Immediacy index 0.49
Eigenfactor 0.00
Article influence 0.00
ISSN 1876-861X

Publisher details

Elsevier

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    • Publisher last reviewed on 03/06/2015
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Estimates of effective dose (E) for cardiovascular CT are obtained from a scanner-provided dose metric, the dose-length product (DLP), and a conversion factor. These estimates may not adequately represent the risk of a specific scan to obese adults. Objective: Our objective was to create dose maps sensitive to patient size and anatomy in the irradiated region from a patient's own CT images and compare measured E (EDoseMap) to doses determined from standard DLP conversion (EDLP) in obese adults. Methods: 21 obese patients (mean body mass index, 39 kg/m(2)) underwent CT of the pulmonary veins, thoracic aorta, or coronary arteries. DLP values were converted to E. A Monte Carlo tool was used to simulate X-ray photon interaction with virtual phantoms created from each patient's image set. Organ doses were determined from dose maps. EDoseMap was computed as a weighted sum of organ doses multiplied by tissue-weighting factors. Results: EDLP (mean ± SD, 5.7 ± 3.3 mSv) was larger than EDoseMap (3.4 ± 2.4 mSv) (difference = 2.3; P < .001). Conclusion: Dose maps derived from patient CT images yielded lower effective doses than DLP conversion methods. Considering over all patient size, organ size, and tissue composition could lead to better dose metrics for obese patients.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: We sought to assess the incremental prognostic value of quantitative plaque characterization beyond established CT risk scores.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: Previous studies reported on the impact of pulmonary vein orientation on pulmonary vein isolation (PVI) outcome in atrial fibrillation patients undergoing laser balloon PVI and point-by-point radiofrequency ablation. Objective: Demonstrate the association between pulmonary vein orientation and PVI outcome after multi-electrode radiofrequency ablation. Methods: 120 patients undergoing PVI with a circular MER catheter were included. A left atrial ECG-triggered CT was performed in all patients prior to PVI. The orientation of all pulmonary veins at the insertion into the left atrium was measured in the axial and coronal planes. pulmonary veins were classified as having a ventral/dorsal and caudal/cranial orientation depending on the pulmonary vein trunk angle as compared to the median angle. Results: Mean age was 56 years, arrhythmia-free survival after a median follow-up of 20 months was 54.2%. Left upper pulmonary vein orientation within the coronal plane was associated with arrhythmia-free survival, ranging from 58% with a cranial pulmonary vein orientation to 21% with a caudal orientation (p = 0.003). Similarly, arrhythmia-free survival was 50% in patients with a caudal orientation and 33% in patients with a cranial orientation of the left lower pulmonary vein in the coronal plane (p = 0.036). Pulmonary vein orientation in the axial plane and orientation of the right-sided pulmonary veins were not associated with arrhythmia-free survival. Multivariable analysis showed an independent association between both left upper (hazard ratio 2.8, p = 0.001) and left lower (hazard ratio 0.490, p = 0.034) pulmonary vein orientation and arrhythmia-free survival. Conclusion: In MER ablation, orientation of the left upper and caudalpulmonary veins in the coronal plane were independently associated with arrhythmia-free survival after multi-electrode PVI.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: Rotational atherectomy (rotablation) has been proposed as a potentially superior strategy for percutaneous coronary intervention (PCI) in complex and severely calcified lesions. Objectives: We hypothesized that a per-lesion coronary artery calcium score determined by multidetector computed tomography (MDCT) would be useful for predicting the requriement for rotablation during PCI. Methods: MDCT was performed in patients with stable angina pectoris who were scheduled for first PCI. In 116 consecutive subjects (168 target lesions) with successful PCI, MDCT and quantitative coronary angiography (QCA) data were retrospectively evaluated regarding their ability to predict rotablation. Results: PCI without rotablation was performed in 105 patients (154 lesions), and rotablation was added in 11 patients (14 lesions). Patients with rotablation had significantly higher SYNTAX scores (p = 0.007) and total calcium scores (p < 0.001) than those without rotablation. Per-lesion, a lesion length ≥20 mm and diameter stenosis ≥74% on QCA as well as a per-lesion calcium score ≥453 and calcification arc ≥270 in MDCT predicted rotablation. After adjustment for potential confounding variables, a high per-lesion calcium score was an independent predictor of rotablation (odds ratio 31.3, 95% confidence interval 2.8-345, p = 0.005, sensitivity 93% and specificity 88%). Conclusion: The extent of target lesion calcification in MDCT, a simple marker of calcified plaque, is useful for predicting the need for rotablation during PCI.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: Epicardial adipose tissue (EAT) volume is associated with plaque formation and cardiovascular event risk, its density may reflect tissue composition and metabolic activity. Objectives: Global and regional associations between EAT volume and density, ischemia and coronary calcium were investigated using a novel automatic quantitative measurement software. Methods: 71 patients with an intermediate pre-test probability for coronary artery disease and inducible ischemia by SPECT were matched to two same-gender controls (total of 213 patients, 90% male, age 60 ± 10 years). Non-contrast CT for assessment of EAT volume, density (in Hounsfield Unit [HU]) and coronary calcium score (CCS) was performed. Results: Global EAT volume was significantly increased in ischemic patients compared to controls (96 ± 49 vs. 82 ± 36 cm(3), p = 0.04), density showed no significant difference (-75.6 ± 4.3 vs. -75.1 ± 4.1HU, p = 0.63). EAT volume and density differed significantly between coronary territories (LAD: 37 ± 18 cm(3), -77.8 ± 4.5HU; LCx: 16 ± 9 cm(3), -73.9 ± 4.1HU; RCA: 36 ± 17 cm(3), -71.7 ± 4.8HU, p < 0.001). For regional ischemia, only LCx territory showed a significantly higher EAT volume (18 ± 8 vs. 16 ± 9 cm(3), p = 0.048). Multivariable logistic regression revealed a significant association with ischemia for EAT volume (OR 2.09 (1.0; 4.3), p = 0.049) and CCS (OR 1.43 (1.1; 1.9), p = 0.006). EAT volume significantly improved discrimination of ischemia over CCS (Integrated Discrimination Improvement: 3.5%, 95%CI: 1.1-6.1%, p = 0.004). Hypertension was the only risk factor significantly influencing EAT volume and density (98 ± 48 vs. 78 ± 31 cm(3), p = 0.002, -76.0 ± 4.1 vs. -74.5 ± 4.1 HU, p = 0.01). Conclusions: EAT volume is associated with myocardial ischemia and improves the discriminative power for independent ischemia prediction over CCS. In hypertensive patients, EAT is characterized by lower density and higher volumes.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: Clostridium septicum (C. septicum) aortitis is a rare but highly fatal infection that has a strong association with occult malignancy. Aneurysmal transformation of C. septicum aortitis is common and has been reported to occur in as little as 1 to 3 weeks. We report a case of C. septicum Aortitis with concomitant adenocarcinoma of the ascending colon detected via CT scan. Imaging findings of colonic malignancy with aortitis are highly suggestive of infection with C. septicum. Given the high associated mortality and rapid progression, early recognition on imaging could have life saving implications. Additionally, imaging findings of aortitis in conjunction with C. septicum bacteremia should prompt the careful evaluation for malignancy, most notably colonic or hematologic.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: There have been no reports about the diagnostic ability of coronary computed tomography angiography (CTA) in evaluating collateral channels used for retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Objective: We investigated the ability and diagnostic accuracy of coronary CTA compared with invasive coronary angiography to detect collaterals used in retrograde CTO PCI and to compared the success rates for wire crossing between collaterals that are detectable and not detectable in coronary CTA. Methods: We retrospectively reviewed data from 43 patients (55 collaterals) who underwent coronary CTA and PCI for CTO with the retrograde approach. We compared the ability of coronary CTA to visualize collaterals to invasive coronary angiography and evaluated the rates of successful wire crossing between CTA-visible and invisible collaterals. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of coronary CTA for detecting collaterals which were used for the retrograde approach was 100.0%, 50.0%, 65.9%, 100.0%, and 74.5%, respectively. Guidewire collateral crossing was more successful in CT-visible collaterals than those not detectable in CT (74.1% vs. 46.4%, p = 0.034). There were fewer collateral vessel injuries in CTA-visible collaterals (11.1% vs. 32.1%, p = 0.041). Conclusion: Coronary CTA provides good visualization of collaterals used in retrograde CTO PCI. For retrograde guidewire crossing, a higher success rate with fewer complications was observed in CTA-visible collaterals than in those not detectable in coronary CTA.
    No preview · Article · Jan 2016 · Journal of cardiovascular computed tomography

  • No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography

  • No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: If undetected, infrarenal Abdominal Aortic Aneurysm (AAA) growth can lead to rupture, a high-mortality complication. Some AAA patients exhibit inhomogeneous luminal contrast attenuation at first-pass CT angiography (CTA). This study assesses the association between this observation and aneurysm growth. Methods: Sixty-seven consecutive pre-repair AAA CTAs were included in this retrospective study. The "Gravitational Gradient" (GG), defined as the ratio of the mean attenuation in a region-of-interest placed posteriorly to that in a region-of-interest placed anteriorly within the lumen of the aortic aneurysm on a single axial slice, and the maximum aneurysm diameter were measured from each CT data set. "AAA Contrast Inhomogeneity" was defined as the absolute value of the difference between the GG and 1.0. Univariate and multivariate logistic regression was used to assess the association of aneurysm growth >0.4 and >1.0 cm/year to AAA Contrast Inhomogeneity, aneurysm diameter, patient characteristics and cardiovascular co-morbidities. Results: AAA Contrast Inhomogeneity was not correlated to aneurysm diameter (p = 0.325). In multivariable analysis that included initial aneurysm diameter and AAA Contrast Inhomogeneity, both factors were significantly associated with rapid aneurysm growth (initial diameter: p = 0.029 and 0.011, and, AAA Contrast Inhomogeneity: p = 0.045 and 0.048 for growth >0.4 cm/year and >1 cm/year respectively). Conclusions: AAA Contrast Inhomogeneity is a common observation in first-pass CTA. It is associated with rapid aneurysm growth, independent of aneurysm diameter.
    No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: In coronary CT angiography (CTA), stenosis evaluation is limited by artifacts such as blooming. Monochromatic reconstructions from single-source dual-energy coronary CTA have shown to reduce image noise and improve image quality. Objective: The aim of this study was to analyze the impact of monochromatic coronary CTA reconstructions on stenosis quantification using invasive coronary angiography (ICA) as standard of reference. Methods: Patients who were referred for clinically indicated assessment of coronary artery disease underwent coronary CTA and ICA within 4 months. In standard polychromatic coronary CTA images as well as 8 monochromatic series (50keV-140 keV) luminal narrowing of coronary lesions was measured and compared to ICA with quantitative coronary angiography (QCA). Results: In 37 patients with a mean age of 63.4 ± 8.2 years and a broad range of BMI (19.9-45.5 kg/m2), 124 lesions were studied. Throughout all the reconstructions, CT measurements showed a significant correlation with QCA (P < 0.001), except for reconstructions with 50 keV. Luminal narrowing of calcified and partly calcified lesions was generally overestimated, and underestimated in noncalcified plaques. After stepwise regression, reconstructions with 90 keV showed the best relation to QCA (P < 0.001, R2 = 0.9). Analysis by plaque composition suggested a superior performance of reconstructions at 90 keV for calcified and partly calcified plaques and at 140 keV for noncalcified plaques. Conclusion: The use of monochromatic reconstructions improves the overall accuracy of lesion assessment. Combining reconstructions at 90 keV for calcified and partly calcified lesions and at 140 keV for noncalcified lesions yielded optimal results. Thus monochromatic reconstruction bears the potential to improve accuracy of coronary CTA.
    No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography

  • No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography
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    ABSTRACT: Background: Recently several publications described the diagnostic value of coronary CT angiography (coronary CTA) derived fractional flow reserve (CTA-FFR). For a recently introduced on-site CTA-FFR application, detailed methodology and factors potentially affecting performance have not yet been described. Objective: To provide a methodological background for an on-site CTA-FFR application and evaluate the effect of patient and acquisition characteristics. Methods: The on-site CTA-FFR application utilized a reduced-order hybrid model applying pressure drop models within stenotic regions. In 116 patients and 203 vessels the diagnostic performance of CTA-FFR was investigated using invasive FFR measurements as a reference. The effect of several potentially relevant factors on CTA-FFR was investigated. Results: 90 vessels (44%) had a hemodynamically relevant stenosis according to invasive FFR (threshold ≤0.80). The overall vessel-based sensitivity, specificity and accuracy of CTA-FFR were 88% (CI 95%:79-94%), 65% (55-73%) and 75% (69-81%). The specificity was significantly lower in the presence of misalignment artifacts (25%, CI: 6-57%). A non-significant reduction in specificity from 74% (60-85%) to 48% (26-70%) was found for higher coronary artery calcium scores. Left ventricular mass, diabetes mellitus and large vessel size increased the discrepancy between invasive FFR and CTA-FFR values. Conclusions: On-site calculation of CTA-FFR can identify hemodynamically significant CAD with an overall per-vessel accuracy of 75% in comparison to invasive FFR. The diagnostic performance of CTA-FFR is negatively affected by misalignment artifacts. CTA-FFR is potentially affected by left ventricular mass, diabetes mellitus and vessel size.
    No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography
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    ABSTRACT: Cardiac metastases from RCC in the absence of transvenous spread are rare. We present a case of cardiac metastases from RCC demonstrating usefulness of cardiac CT in planning surgical management, which provides superior spatial resolution for evaluation of relationship between the tumor and coronary arteries.
    No preview · Article · Dec 2015 · Journal of cardiovascular computed tomography