MDCT an alternative in evaluating causes of dilated cardiomyopathy

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A new study has shown that multidetector CT (MDCT) for screening coronary causes of dilated cardiomyopathy is a positive alternative to diagnose ischemic etiology, according to an article published online at

"The appeal of MDCT compared with conventional coronary angiography, particularly in this subset of patients, is that it is rapid and noninvasive, thus avoiding catheter-associated risk and patient discomfort," said Daniele Andreini, MD, of the University of Milan, Italy. Andreini and colleagues published their study results in the May 22 issue of the Journal of the American College of Cardiology.

Their study used 16-slice MDCT in 61 subjects with dilated cardiomyopathy of unknown etiology. These patients had also undergone conventional angiography. The researchers also evaluated 139 patients with suspected coronary artery disease (CAD) using the same techniques.

Of patients with dilated cardiomyopathy, MDCT was able to identify all normal and diseased coronary artery segments that were found by standard coronary angiography. MDCT imaging also performed well for patients with normal heart function, though sensitivity and negative predictive values turned out noticeably lower in these patients than in patients with dilated cardiomyopathy.

"The higher sensitivity and negative predictive value in dilated cardiomyopathy patients may be explained by a low pretest likelihood of CAD and a more accurate imaging of the coronary artery tree," the authors wrote. "It is likely that the reduction of cardiac and coronary motion due to the severe systolic dysfunction and the increased left ventricular end-diastolic volume of dilated cardiomyopathy patients played a positive role in image quality and diagnostic accuracy."

"Thanks to its feasibility, rapidity, lower cost, and possible utilization as an outpatient examination, [MDCT] may be preferable to invasive coronary angiography in [dilated cardiomyopathy] patients," the researchers concluded.