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Assessment of the coronary arteries with electron beam computed tomography

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Cardiovascular Imaging

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 186))

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Summary

Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity in the western industrialized countries. Recent studies demonstrate the feasibility of successful primary and secondary prevention. However, the detection of early stages of CAD is an unresolved issue. Whereas sensitivity and specificity of traditional risk factor assessment and stress tests are limited, the analysis of coronary calcification allows one to obtain a direct sign of coronary atherosclerosis. This concept has been applied using fluoroscopy and conventional computed tomography (CT). However, the exact localization and quantification of coronary calcification only became possible with the advent of electron beam CT (EBCT). This new method showed a high prevalence of coronary calcification in the asymptomatic population. With the definition of a standardized ’calcium score’ the normal age-specific distribution and amount of coronary calcification. was investigated. EBCT proved to be more sensitive in the diagnosis of both nonobstructive and obstructive CAD than risk factor analysis and stress testing, respectively. Obstructive CAD, however, cannot yet be predicted with high enough accuracy. A close correlation of EBCT coronary calcification was found to exist with: a) the total coronary plaque volume defined by histo-pathology; b) intracoronary ultrasound findings; c) the number of coronary risk factors; and d) the coronary prognosis. Using EBCT, a reliable noninvasive identification of persons at risk was obtained for the first time. Guidelines for the use of EBCT in the early diagnosis and treatment of CAD are being developed.

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Authors
  1. Axel Schmermund
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  2. Dietrich Baumgart
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  3. Günter Görge
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  4. Rainet Seibel
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  5. Dietrich Grönemeyer
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  6. Raimund Erbel
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Editor information

Editors and Affiliations

  1. Laboratory for Clinical and Experimental Image Processing (LKEB), Department of Diagnostic Radiology and Nuclear Medicine, Department of Cardiology, Leiden University Hospital, The Netherlands

    Johan H. C. Reiber

  2. Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands

    Johan H. C. Reiber

  3. Department of Cardiology, Leiden University Hospital, The Netherlands

    Ernst E. van der Wall

  4. Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands

    Ernst E. van der Wall

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© 1996 Kluwer Academic Publishers

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Schmermund, A., Baumgart, D., Görge, G., Seibel, R., Grönemeyer, D., Erbel, R. (1996). Assessment of the coronary arteries with electron beam computed tomography. In: Reiber, J.H.C., van der Wall, E.E. (eds) Cardiovascular Imaging. Developments in Cardiovascular Medicine, vol 186. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0291-6_41

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  • DOI: https://doi.org/10.1007/978-94-009-0291-6_41

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6616-7

  • Online ISBN: 978-94-009-0291-6

  • eBook Packages: Springer Book Archive

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