Coronary CTA Amidst the COVID-19 Pandemic: A Quicker Examination Protocol with Preserved Image Quality Using a Dedicated Cardiac Scanner

Author:

Panajotu Alexisz1,Vecsey-Nagy Milán1ORCID,Jermendy Ádám Levente1,Boussoussou Melinda1,Vattay Borbála1,Kolossváry Márton23ORCID,Zs. Dombrády Örs1,Csobay-Novák Csaba1ORCID,Merkely Béla1,Szilveszter Bálint1

Affiliation:

1. Heart and Vascular Center, Semmelweis University, 1122 Budapest, Hungary

2. Gottsegen National Cardiovascular Center, 29. Haller Street, 1096 Budapest, Hungary

3. Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Bécsi út 96/b, 1034 Budapest, Hungary

Abstract

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.

Funder

National Research, Development and Innovation Office of Hungary

Ministry for Innovation and Technology of Hungary

Therapeutic Development and Bioimaging programs of the Semmelweis University

European Union

Publisher

MDPI AG

Subject

Clinical Biochemistry

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