OBJECTIVES: Cardiac computed tomography perfusion (CTP) using stress testing is an emerging application in the field of cardiac computed tomography. We evaluated @entity1 with acute @entity662 ( @entity662 ) in the @entity341 ( @entity341 ) with evidence of obstructive @entity453 ( @entity453 ), defined as >70% @entity850 on coronary computed tomography angiography (CCTA) and confirmed by invasive coronary angiography (ICA), to evaluate the applicability of resting CTP in the acute @entity662 setting. METHODS: From January to December 2013, 183 low-intermediate risk symptomatic @entity1 with negative cardiac biomarkers and no known @entity453 underwent a rapid CCTA protocol in the @entity341 . Of these, 4 @entity1 (1.4%) had obstructive @entity453 (>= 70% @entity850 ) on CCTA confirmed by ICA. All 183 CCTA studies were evaluated retrospectively with CTP software by a transmural perfusion ratio (TPR) method with a superimposed 17-segment model. A TPR value <0.99 was considered abnormal based on previously published data. RESULTS: A total of four @entity1 were included in this pilot analysis. The duration from resolution of @entity662 to performance of CCTA ranged from 1.6 to 5.0 hours. Three @entity1 underwent revascularization, two with percutaneous coronary intervention (PCI) and one with coronary artery bypass grafting. The fourth @entity1 was managed with aggressive medical therapy. Two @entity1 had multivessel obstructive @entity453 and two @entity1 had @entity453 . The first @entity1 underwent CCTA 5 hours after resolution of @entity662 symptoms. CCTA demonstrated noncalcified obstructive @entity453 in the mid- @entity3980 and mid-right coronary artery. ICA showed good correlation by quantitative coronary assessment (QCA) in both vessels and the @entity1 underwent PCI. CTP analysis demonstrated perfusion defects in the @entity3980 and right coronary artery territories. The second @entity1 underwent CCTA 1.6 hours after resolution of @entity662 symptoms with findings of obstructive ostial left main @entity453 . ICA confirmed obstructive left main @entity453 by QCA and intravascular ultrasound. The @entity1 underwent revascularization with coronary artery bypass grafting. CTP demonstrated perfusion defects in the anterior and lateral wall segments. The third @entity1 was evaluated for @entity662 in the @entity341 with CCTA demonstrating @entity453 10 hours after resolution of symptoms with findings of a @entity850 in the mid- @entity3980 . The @entity1 subsequently underwent ICA demonstrating good correlation to the CCTA findings in the @entity3980 by QCA. CTP analysis revealed perfusion defects in @entity3980 territory. He was successful treated with PCI. The final @entity1 underwent CCTA 5.4 hours following resolution of @entity662 with the finding of an intermediate partially calcified @entity850 in the distal @entity3980 . ICA was performed, with fractional flow reserve demonstrating a hemodynamically insignificant distal @entity3980 at 0.86. CTP detected a perfusion defect in the @entity3980 territory. CONCLUSIONS: When positive, rest CTP may have value in the risk stratification of @entity1 presenting to the @entity341 with nontraumatic acute @entity662 .

Rest-Only Myocardial CT Perfusion in Acute XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity662 :: ('MESH:D002637', 'Disease') :: ['CP', 'chest pain'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency department', 'ED'] @entity3980 :: ('MESH:C535887', 'Disease') :: ['LAD'] @entity453 :: ('MESH:D003324', 'Disease') :: ['CAD', 'single-vessel CAD', 'coronary artery disease'] @entity850 :: ('MESH:D003251', 'Disease') :: ['noncalcified obstructive stenosis', 'stenosis']
@entity662 :: (MESH:D002637,Disease) :: ['Chest Pain']
