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J D Schuijf

Publications and source records attributed to J D Schuijf.

8 recordsLinked to original sources
PubMed2006

Non-invasive anatomical and functional imaging for the detection of coronary artery disease.

Coronary artery disease (CAD) is still an important cause of morbidity and mortality in the Western world. The gold standard for assessing significant coronary artery stenosis is invasive coronary angiography. Several disadvantages of the technique in combination with the fact that a substantial number of patients referred for conventional angiography appear free from significant stenosis have led to the pursuit of non-invasive imaging modalities for the diagnosis of CAD. The traditional modalities for this purpose are gated single-photon emission computed tomography, position emission tomography, (contrast) stress echocardiography and cardiac magnetic resonance (CMR), and these techniques can be characterized as functional imaging techniques as they detect ischaemia. Although the presence of a flow-limiting stenosis can be adequately ruled out with these techniques, atherosclerosis cannot be visualized with functional techniques. For this purpose, non-invasive coronary angiography techniques (computed tomography and CMR) are currently under development. The purpose of this review is to provide the reader an overview of the currently used imaging modalities to detect CAD.

Coronary Artery Disease↗
PubMed2006

Assessment of left ventricular volumes and ejection fraction with 16-slice multi-slice computed tomography; comparison with 2D-echocardiography.

BACKGROUND: In recent years, multi-slice computed tomography (MSCT) has emerged as a rapidly expanding modality for non-invasive assessment of coronary artery disease. Simultaneously, left ventricular (LV) function can be evaluated although this is not yet a routine component of an MSCT examination. Accordingly, the purpose of the present study was to validate assessment of LV function with MSCT using 2D-echocardiography in a large cohort of patients. METHODS: In 70 patients (57 male, 13 female), 16-slice MSCT was performed (Toshiba Aquilion 16, Japan) followed by retrospective analysis of global LV function. For these measurements, 2D-echocardiography served as the standard of reference. RESULTS: For LV volumes, excellent correlations for both end-diastolic volume (EDV) (r=0.97) and end-systolic volume (ESV) (r=0.98) were obtained by linear regression analysis. At Bland-Altman analysis, mean differences (+/-standard deviations) of -1.4 ml+/-11.3 ml and -3.0 ml+/-7.7 ml were observed between MSCT and 2D-echocardiography for LV EDV and LV ESV respectively. As a result, LV EF was slightly overestimated with MSCT (1.7%+/-4.9%, P<0.05). Correlation between the two techniques was excellent (r=0.91). CONCLUSION: In a large cohort of patients, an excellent correlation was observed between 16-slice MSCT and 2D-echocardiography in the evaluation of LV volumes and EF. The addition of LV function analysis to the anatomical MSCT data may potentially enhance the diagnostic and prognostic value of the technique.

Aged↗
PubMed2006

Comprehensive cardiac assessment with multislice computed tomography: evaluation of left ventricular function and perfusion in addition to coronary anatomy in patients with previous myocardial infarction.

OBJECTIVE: To evaluate a comprehensive multislice computed tomography (MSCT) protocol in patients with previous infarction, including assessment of coronary artery stenoses, left ventricular (LV) function and perfusion. PATIENTS AND METHODS: 16-slice MSCT was performed in 21 patients with previous infarction; from the MSCT data, coronary artery stenoses, (regional and global) LV function and perfusion were assessed. Invasive coronary angiography and gated single-photon emission computed tomography (SPECT) served as the reference standards for coronary artery stenoses and LV function/perfusion, respectively. RESULTS: 236 of 241 (98%) coronary artery segments were interpretable on MSCT. The sensitivity and specificity for detection of stenoses were 91% and 97%. Pearson's correlation showed excellent agreement for assessment of LV ejection fraction between MSCT and SPECT (49 (13)% v 53 (12)%, respectively, r = 0.85). Agreement for assessment of regional wall motion was excellent (92%, kappa = 0.77). In 68 of 73 (93%) segments, MSCT correctly identified a perfusion defect as compared with SPECT, whereas the absence of perfusion defects was correctly detected in 277 of 284 (98%) segments. CONCLUSIONS: MSCT permits accurate, non-invasive assessment of coronary artery stenoses, LV function and perfusion in patients with previous infarction. All parameters can be assessed from a single dataset.

Coronary Angiography↗
PubMed2006

[Screening of asymptomatic individuals for coronary disease using CT-calcium measurement in the coronary arteries].

Coronary calcification is a specific marker for coronary atherosclerosis. It is therefore reasonable to assume that the risk ofcardiac events can be assessed by the quantification of the extent of coronary calcium. Until now, the predictive value of coronary calcium and its advantage over conventional risk factors has not been proven by any of the available prospective cohort studies. It is particularly likely that assessment of coronary atherosclerosis will help in the decision to initiate or discard a specific therapy in patients with an intermediate risk for cardiac events. Recently it has been suggested that the Framingham risk score (FRS) be replaced by a score corrected by assessing the amount of coronary calcium, which can be obtained by multislice spiral computed tomography (MSCT). To this end, the Commission Law Population Investigation has approved a study proposal to evaluate the effects of coronary-calcium screening in 4000 asymptomatic individuals with an intermediate likelihood of coronary artery disease. Based on the amount of calcium (calcium score > 100) obtained by MSCT, different treatment strategies will be initiated over a period of 5 years. Hard endpoints will be myocardial infarction, stroke and mortality due to cardiovascular disease.

Biomarkers↗
PubMed2006

Diagnostic and prognostic value of non-invasive imaging in known or suspected coronary artery disease.

The role of non-invasive imaging techniques in the evaluation of patients with suspected or known coronary artery disease (CAD) has increased exponentially over the past decade. The traditionally available imaging modalities, including nuclear imaging, stress echocardiography and magnetic resonance imaging (MRI), have relied on detection of CAD by visualisation of its functional consequences (i.e. ischaemia). However, extensive research is being invested in the development of non-invasive anatomical imaging using computed tomography or MRI to allow detection of (significant) atherosclerosis, eventually at a preclinical stage. In addition to establishing the presence of or excluding CAD, identification of patients at high risk for cardiac events is of paramount importance to determine post-test management, and the majority of non-invasive imaging tests can also be used for this purpose. The aim of this review is to provide an overview of the available non-invasive imaging modalities and their merits for the diagnostic and prognostic work-up in patients with suspected or known CAD.

Coronary Artery Disease↗