Abstract
Background: Coronary CT angiography (CCTA) has in the recent past evolved rapidly due to development of sophisticated multi detector row CT (MDCT). The cardinal indication for CCTA is the evaluation of suspected or known coronary artery disease (CAD). Coronary CTA imaging can detect and characterize atherosclerotic plaques. In addition, it can confirm or exclude luminal stenosis. Other applications include identification and assessment of variations in coronary arterial circulation patterns, evaluation of isolated anomalous coronary vessels, by-pass grafts, coronary stents patency and assessment of left ventricular function. Study objective: This study was set to determine the spectrum, pattern and distribution of imaging findings at Coronary CT angiograms as detected by a 320 row MDCT in patients who had undergone coronary CTA. Study design: A cross sectional study. Setting: Plaza Imaging Solutions Limited, Nairobi, Kenya. Subjects: Patients imaged at Plaza Imaging Solutions Limited over a period of 6 months. Materials and methods: Study subjects: Consecutive patients referred for coronary CTA at Plaza Imaging Solutions Limited and met the inclusion criteria. Ethical considerations: Ethical approval and clearance was obtained from the KNH-UON Ethics Review Board. Written and verbal consent was obtained from the participating persons and/or their kin Tools: A two-part data collection form was used to manually record all the relevant data. The information included socio-demographics, clinical and imaging finding of Coronary CTA. A low dose calcium scan and a standard coronary CTA were performed. Each Coronary CTA study was reviewed by a radiologist together with the researcher. Statistical analysis: Data analysis was performed using the Statistical Package for Social Sciences (SPSS) employing relevant statistical tests. The results were presented in form of frequency tables, graphs and charts and discussed accordingly. Statistical significance was set at p 55 years of age with symptomatic features of ischemic heart disease. Coronary calcium scoring is not necessary in individuals undergoing coronary CTA in this setting (black race) as no correlation is found between total calcium score and atherosclerotic disease burden.
Highlights
Coronary CT angiography (CCTA) has in the recent past evolved rapidly due to development of sophisticated multi detector row CT (MDCT)
Because reduction in coronary blood flow almost always is the cause of the imbalance, Ischemic heart disease (IHD) is known as coronary artery disease
A total of 38 subjects who underwent coronary CT Angiogram (CTA) were recruited into the study over the six-month period
Summary
Coronary CT angiography (CCTA) has in the recent past evolved rapidly due to development of sophisticated multi detector row CT (MDCT). Conclusion: The study demonstrated common occurrence of coronary atherosclerotic plaques in the older age group with lower incidence seen in younger individuals aged less than 40 years of age It demonstrated the wide spectrum of luminal effect caused by the atherosclerotic plaques. Recommendations: Based on the findings and conclusions of this study, a recommendation is made for coronary CTA to be performed in the older age group of > 55 years of age with symptomatic features of ischemic heart disease. The luminal narrowing is caused by a buildup of atherosclerotic plaques on the inner walls of the coronary vessels resulting in gradual or abrupt reduction or complete cessation of blood supply to the heart structures. The resultant reduction in blood supply to the myocardium and its components due to atherosclerotic plaques causing luminal narrowing may either be symptomatic or asymptomatic, occur during activity or at rest and may result in a myocardial infarction or sudden death. [1, 2, 3]
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