Coronary computed tomography angiography (CCTA) has emerged as an important tool for planning percutaneous coronary intervention (PCI). While it has traditionally been employed for diagnostic purposes, increasing evidence and real-world experience suggest that CCTA can be used for the pre-procedural planning of PCI and inform patient triage, shared decision-making, case complexity, and resource use. This approach mirrors how computed tomography angiography is routinely used to plan structural in…
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Right atrial-to-pulmonary vein fenestration causing partial unroofing of right superior pulmonary vein: Findings on virtual dissection
A 4-year-old acyanotic child presented with recurrent respiratory tract infections and exertional dyspnea. Transthoracic echocardiography demonstrated a large ostium secundum atrial septal defect (ASD) with deficient rims and left to right shunting across the defect. There was presence of severe valvular pulmonic stenosis with a transvalvular gradient of 70 mm of Hg. There was mild tricuspid regurgitation with normal biventricular functions. A suspicion of an associated partial anomalous pulmon…
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CAC progression in men and women: Is there an inflection at menopause?
Coronary artery disease (CAD) is a leading cause of mortality in women, especially after menopause. Research has showed that cardiovascular risk increases 2–3 years after menopause and within 10 years, women have nearly equivalent cardiovascular risk as compared to men.1 Coronary artery calcium (CAC) scoring via non-contrast cardiac commuted tomography (CT) allows for early detection of subclinical atherosclerosis progression and is useful in risk stratification.
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Diagnostic utility of unrequested non-gated chest computed tomography in patients with suspected coronary artery disease: A comparative analysis with SPECT-MPI and invasive coronary angiography
Non-gated chest computed tomography (CT) is not typically used to diagnose coronary artery disease (CAD). This project aimed to establish the limits of interpretability for non-gated chest CT scans in patients presenting with chest pain or suspected obstructive CAD. It compared the diagnostic accuracies of two luminal stenosis interpretative approaches: a 50 % obstructive CAD threshold and a patient-level stenosis method. The latter categorized chest CT into four groups based on the most severe…
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Letter to the Editor-referencing JCCT-D-25-00140- Racial referral bias in cardiac computed tomography: Differences, disparities or discrimination?
We thank Dr. Sharma and Professor Connolly for their interest in our study. We also congratulate them on their own data, demonstrating an absence of bias in their referrals for cardiac CT. It emphasizes the global need to recognize and understand the reasons for potential biases in clinical practice but demonstrates the potential ability to overcome bias. It also reinforces the importance for institutions to internally audit their practices as there may be unconscious biases amongst physicians o…
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The effect of diabetes on plaque, stenosis, and coronary artery calcium score
Diabetes mellitus (DM) is a major public health issue and a significant risk factor for atherosclerotic cardiovascular disease (ASCVD), which contributes to up to 80 % of deaths in individuals with diabetes.1 The elevated risk is primarily due to hyperglycemia-induced inflammation, oxidative stress, and endothelial dysfunction, leading to increased coronary plaque burden and rupture risk. Coronary Computed Tomography Angiography (CCTA) enables detailed assessment of plaque burden using metrics …
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Contemporary trends in utilization of pediatric cardiac imaging in children's hospitals
There has been an increase in availability and utilization of cardiac CT (CCT) and magnetic resonance (CMR) imaging in pediatric cardiology. Understanding trends in their utilization can provide foundational data for defining appropriate use of these tests in pediatrics, and guide resource distribution enhance access to these modalities.
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Semiquantitative metrics of coronary artery disease burden: Intra-individual comparison between ultrahigh-resolution photon-counting detector CT and energy-integrating detector CT
Quantitative coronary stenosis and plaque volumes have demonstrated intra-individual differences between ultrahigh-resolution (UHR) photon-counting detector (PCD)-CT and energy-integrating detector (EID)-CT. This study aimed to assess the impact of UHR PCD-CT on semiquantitative scores of coronary artery disease (CAD) burden compared with EID-CT.
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Access to CCTA at safety-net hospitals across the United States
Coronary CT angiography (CCTA) has received a class 1A indication for the evaluation of patients with acute and stable chest pain after studies revealed the use of CCTA reduces mortality, rates of MI, unnecessary invasive procedures, and healthcare expenditure compared to traditional stress testing. Despite this recommendation, hospitals across the U.S. have not adopted CCTA at levels expected for standard of care. We sought to evaluate the availability of CCTA at U.S. safety-net hospitals.
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The association between peripheral medial and intimal arterial calcification patterns with central arterial stiffness in individuals with type 2 diabetes mellitus: The cross-sectional Early-HFpEF study
Animal studies suggest that medial arterial calcification (MAC) increases arterial stiffness, which in turn could lead to cardiovascular disease (CVD), but human studies are lacking. We evaluated the associations of peripheral arterial calcification pattern and quantity with arterial stiffness in individuals with type 2 diabetes mellitus (T2DM).