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The Long March into Clinical Practice: Cardiac CT and Its Competitors

  • Seth UretskyEmail author
  • Alan Rozanski
  • Daniel Berman
Chapter
Part of the Contemporary Medical Imaging book series (CMI)

Abstract

In the early twentieth century, control of infectious diseases, increasing longevity, and poor lifestyles resulted in chronic diseases becoming the major cause of disability and death. By the 1920s, coronary artery disease (CAD) became the leading cause of death in the United States. As treatments emerged to treat CAD, it became important to develop means for identifying those patients at risk for developing the disease and its complications. Initial diagnostic work in this regard was initiated even prior to the advent of exercise electrocardiography. In the 1920s, Master developed his famous “two-step” stress test, which allowed physicians to assess patients’ functional capacity in a semiquantitative manner and to provoke angina symptoms through physical activity. In the 1950s, treadmill testing was implemented, and in 1963, Robert Bruce published his protocol for performing graded multistage treadmill exercise with electrocardiographic monitoring, a protocol that is still used today. This development of the Bruce protocol treadmill exercise was timely since the 1960s saw the introduction of cardiac catheterization and coronary bypass surgery. With this dramatic new treatment option, a need emerged to accurately identify those patients who were at risk for cardiac events and thus potential beneficiaries of coronary artery bypass surgery.

Keywords

Cardiac CT Coronary artery disease and cardiac CT American Society of Nuclear Cardiology formation Stress echocardiography history Coronary artery calcium (CAC) scanning with electron beam CT Coronary CTA Nuclear cardiology advances 

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References

  1. 1.
    Dalen JE, et al. The epidemic of the 20(th) century: coronary heart disease. Am J Med. 2014;127(9):807–12.CrossRefGoogle Scholar
  2. 2.
    Master AM. The two-step exercise electrocardiogram: a test for coronary insufficiency. Ann Intern Med. 1950;32(5):842–63.CrossRefGoogle Scholar
  3. 3.
    Bruce RA, et al. Exercising testing in adult normal subjects and cardiac patients. Pediatrics. 1963;32:SUPPL 742–56.Google Scholar
  4. 4.
    Coplan NL. Evaluation of patients for coronary artery bypass surgery: the role of exercise testing. Am Heart J. 1991;122(6):1800–2.CrossRefGoogle Scholar
  5. 5.
    Mark DB, et al. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987;106(6):793–800.CrossRefGoogle Scholar
  6. 6.
    Zaret BL, et al. Noninvasive regional myocardial perfusion with radioactive potassium. Study of patients at rest, with exercise and during angina pectoris. N Engl J Med. 1973;288(16):809–12.CrossRefGoogle Scholar
  7. 7.
    Berman DS, et al. Noninvasive detection of regional myocardial ischemia using rubidium-81 and the scintillation camera: comparison with stress electrocardiography in patients with arteriographically documented coronary stenosis. Circulation. 1975;52(4):619–26.CrossRefGoogle Scholar
  8. 8.
    Wackers FJ, et al. Prognostic significance of normal quantitative planar thallium-201 stress scintigraphy in patients with chest pain. J Am Coll Cardiol. 1985;6(1):27–30.CrossRefGoogle Scholar
  9. 9.
    Germano G, et al. Quantitative LVEF and qualitative regional function from gated thallium-201 perfusion SPECT. J Nucl Med. 1997;38(5):749–54.PubMedGoogle Scholar
  10. 10.
    Garcia EV, Maddahi J, Berman DS, Waxman A. Space-time quantitation of thallium-201 myocardial scintigraphy. J Nucl Med. 1981;22(4):309–17.PubMedGoogle Scholar
  11. 11.
    Garcia EV, Van Train K, Maddahi J, Prigent F, Friedman J, Areeda J, Waxman A, Berman DS. Quantification of rotational thallium-201 myocardial tomography. J Nucl Med. 1985;26(1):17–26.PubMedGoogle Scholar
  12. 12.
    Ladenheim ML, et al. Extent and severity of myocardial hypoperfusion as predictors of prognosis in patients with suspected coronary artery disease. J Am Coll Cardiol. 1986;7(3):464–71.CrossRefGoogle Scholar
  13. 13.
    Weiss AT, et al. Transient ischemic dilation of the left ventricle on stress thallium-201 scintigraphy: a marker of severe and extensive coronary artery disease. J Am Coll Cardiol. 1987;9(4):752–9.CrossRefGoogle Scholar
  14. 14.
    Berman DS, et al. Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: a clinical validation study. J Am Coll Cardiol. 1993;22(5):1455–64.CrossRefGoogle Scholar
  15. 15.
    Hachamovitch R, et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107(23):2900–7.CrossRefGoogle Scholar
  16. 16.
    Rozanski A, et al. Comparison of long-term mortality risk following normal exercise vs adenosine myocardial perfusion SPECT. J Nucl Cardiol. 2010;17(6):999–1008.CrossRefGoogle Scholar
  17. 17.
    Rozanski A, et al. Long-term mortality following normal exercise myocardial perfusion SPECT according to coronary disease risk factors. J Nucl Cardiol. 2014;21(2):341–50.CrossRefGoogle Scholar
  18. 18.
    Supariwala A, et al. Influence of mode of stress and coronary risk factor burden upon long-term mortality following normal stress myocardial perfusion single-photon emission computed tomographic imaging. Am J Cardiol. 2013;111(6):846–50.CrossRefGoogle Scholar
  19. 19.
    Hachamovitch R, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation. 1998;97(6):535–43.CrossRefGoogle Scholar
  20. 20.
    Kang X, et al. Incremental prognostic value of myocardial perfusion single photon emission computed tomography in patients with diabetes mellitus. Am Heart J. 1999;138(6 Pt 1):1025–32.CrossRefGoogle Scholar
  21. 21.
    Yao SS, et al. Practical applications in stress echocardiography: risk stratification and prognosis in patients with known or suspected ischemic heart disease. J Am Coll Cardiol. 2003;42(6):1084–90.CrossRefGoogle Scholar
  22. 22.
    Rumberger JA, et al. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation. 1995;92(8):2157–62.CrossRefGoogle Scholar
  23. 23.
    Budoff MJ, et al. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol. 2007;49(18):1860–70.CrossRefGoogle Scholar
  24. 24.
    Detrano R, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med. 2008;358(13):1336–45.CrossRefGoogle Scholar
  25. 25.
    Polonsky TS, et al. Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA. 2010;303(16):1610–6.CrossRefGoogle Scholar
  26. 26.
    Nasir K, et al. Interplay of coronary artery calcification and traditional risk factors for the prediction of all-cause mortality in asymptomatic individuals. Circ Cardiovasc Imaging. 2012;5(4):467–73.CrossRefGoogle Scholar
  27. 27.
    Silverman MG, et al. Impact of coronary artery calcium on coronary heart disease events in individuals at the extremes of traditional risk factor burden: the Multi-Ethnic Study of Atherosclerosis. Eur Heart J. 2014;35(33):2232–41.CrossRefGoogle Scholar
  28. 28.
    Yeboah J, et al. Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA. 2012;308(8):788–95.CrossRefGoogle Scholar
  29. 29.
    Min JK, et al. Age- and sex-related differences in all-cause mortality risk based on coronary computed tomography angiography findings results from the International Multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) of 23,854 patients without known coronary artery disease. J Am Coll Cardiol. 2011;58(8):849–60.CrossRefGoogle Scholar
  30. 30.
    Shaw LJ, et al. Why all the focus on cardiac imaging? JACC Cardiovasc Imaging. 2010;3(7):789–94.CrossRefGoogle Scholar
  31. 31.
    Rozanski A, Muhlestein JB, Berman DS. Primary prevention of CVD: the role of imaging trials. JACC Cardiovasc Imaging. 2017;10(3):304–17.CrossRefGoogle Scholar
  32. 32.
    Goldstein JA, et al. The CT-STAT (coronary computed tomographic angiography for systematic triage of acute chest pain patients to treatment) trial. J Am Coll Cardiol. 2011;58(14):1414–22.CrossRefGoogle Scholar
  33. 33.
    Goldstein JA, et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol. 2007;49(8):863–71.CrossRefGoogle Scholar
  34. 34.
    Litt HI, et al. CT angiography for safe discharge of patients with possible acute coronary syndromes. N Engl J Med. 2012;366(15):1393–403.CrossRefGoogle Scholar
  35. 35.
    Douglas PS, et al. Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med. 2015;372:1291–300.CrossRefGoogle Scholar
  36. 36.
    Hoffmann U, et al. Coronary CT angiography versus standard evaluation in acute chest pain. N Engl J Med. 2012;367(4):299–308.CrossRefGoogle Scholar
  37. 37.
    Levsky JM, Travin MI, Haramati LB. Coronary computed tomography angiography versus radionuclide myocardial perfusion imaging in patients with chest pain admitted to telemetry: a randomized, controlled trial. Ann Intern Med. 2016;164(2):133–4.CrossRefGoogle Scholar
  38. 38.
    Uretsky S, et al. Comparative effectiveness of coronary CT angiography vs stress cardiac imaging in patients following hospital admission for chest pain work-up: the Prospective First Evaluation in Chest Pain (PERFECT) Trial. J Nucl Cardiol. 2017;24(4):1267–78.CrossRefGoogle Scholar
  39. 39.
    Linde JJ, et al. Long-term clinical impact of coronary CT angiography in patients with recent acute-onset chest pain: the randomized controlled CATCH trial. JACC Cardiovasc Imaging. 2015;8(12):1404–13.CrossRefGoogle Scholar
  40. 40.
    Investigators, S.-H. CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet. 2015;385(9985):2383–91.CrossRefGoogle Scholar
  41. 41.
    Hulten E, et al. Outcomes after coronary computed tomography angiography in the emergency department: a systematic review and meta-analysis of randomized, controlled trials. J Am Coll Cardiol. 2013;61(8):880–92.CrossRefGoogle Scholar
  42. 42.
    Williams MC, et al. Use of coronary computed tomographic angiography to guide management of patients with coronary disease. J Am Coll Cardiol. 2016;67(15):1759–68.CrossRefGoogle Scholar
  43. 43.
    Cury RC, et al. Dipyridamole stress and rest myocardial perfusion by 64-detector row computed tomography in patients with suspected coronary artery disease. Am J Cardiol. 2010;106(3):310–5.CrossRefGoogle Scholar
  44. 44.
    Min JK, et al. Diagnostic accuracy of fractional flow reserve from anatomic CT angiography. JAMA. 2012;308(12):1237–45.CrossRefGoogle Scholar
  45. 45.
    Norgaard BL, et al. Diagnostic performance of noninvasive fractional flow reserve derived from coronary computed tomography angiography in suspected coronary artery disease: the NXT trial (analysis of coronary blood flow using CT angiography: next steps). J Am Coll Cardiol. 2014;63(12):1145–55.CrossRefGoogle Scholar
  46. 46.
    Rocha-Filho JA, et al. Incremental value of adenosine-induced stress myocardial perfusion imaging with dual-source CT at cardiac CT angiography. Radiology. 2010;254(2):410–9.CrossRefGoogle Scholar
  47. 47.
    Murthy VL, et al. Improved cardiac risk assessment with noninvasive measures of coronary flow reserve. Circulation. 2011;124(20):2215–24.CrossRefGoogle Scholar
  48. 48.
    Berman DS, et al. Phase II safety and clinical comparison with single-photon emission computed tomography myocardial perfusion imaging for detection of coronary artery disease: flurpiridaz F 18 positron emission tomography. J Am Coll Cardiol. 2013;61(4):469–77.CrossRefGoogle Scholar
  49. 49.
    Baber U, et al. Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: the BioImage study. J Am Coll Cardiol. 2015;65(11):1065–74.CrossRefGoogle Scholar
  50. 50.
    Laclaustra M, et al. Femoral and carotid subclinical atherosclerosis association with risk factors and coronary calcium: the AWHS study. J Am Coll Cardiol. 2016;67(11):1263–74.CrossRefGoogle Scholar
  51. 51.
    Fernandez-Friera L, et al. Prevalence, vascular distribution, and multiterritorial extent of subclinical atherosclerosis in a middle-aged cohort: the PESA (progression of early subclinical atherosclerosis) study. Circulation. 2015;131(24):2104–13.CrossRefGoogle Scholar
  52. 52.
    Berman DS, Arnson Y, Rozanski A. Coronary artery calcium scanning: the Agatston score and beyond. JACC Cardiovasc Imaging. 2016;9(12):1417–9.CrossRefGoogle Scholar
  53. 53.
    Rozanski A, Slomka P, Berman SD. Extending the use of coronary calcium scanning to clinical rather than just screening populations: ready for prime time. Circ Cardiovasc Imaging. 2016;9(5):e004876.CrossRefGoogle Scholar
  54. 54.
    Rozanski A, Cohen R, Uretsky S. The coronary calcium treadmill test: a new approach to the initial workup of patients with suspected coronary artery disease. J Nucl Cardiol. 2013;20(5):719–30.CrossRefGoogle Scholar
  55. 55.
    Rozanski A, et al. Temporal trends in the frequency of inducible myocardial ischemia during cardiac stress testing: 1991 to 2009. J Am Coll Cardiol. 2013;61(10):1054–65.CrossRefGoogle Scholar
  56. 56.
    Berman DS, Germano G, Slomka PJ. Improvement in PET myocardial perfusion image quality and quantification with flurpiridaz F 18. J Nucl Cardiol. 2012;19(Suppl 1):S38–45.CrossRefGoogle Scholar

Copyright information

© Humana Press 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineGagnon Cardiovascular Institute, Morristown Medical CenterMorristownUSA
  2. 2.The Division of CardiologyMount Sinai St. Luke’s Hospital, Mount Sinai HeartNew YorkUSA
  3. 3.Department of Imaging and Medicine and the Burns Allen Research Institute, Cedars-Sinai Medical CenterLos AngelesUSA

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