Coronary Anatomy and Physiology Using Multidetector Dual Source Computed Tomography With Adenosine Enhancement: Comparative Study With SPECT Imaging: Pilot Studies I/II
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 34
- 试验地点
- 1
- 主要终点
- To show that adenosine enhanced DSCT will enhance regular Multidetector Spiral Computed Tomography (MSCT) "diagnostic power" to detect significant (e.g., > 50%) coronary stenosis
研究概览
简要总结
Researchers hope that this new non-invasive multi-detector scanner (DSCT) will provide diagnostic information comparable to the combination of traditional SPECT (for function and blood flow) and CT imaging (for a precise anatomical view).
详细描述
The DSCT scanner is able to assess cardiac blood flow (myocardial perfusion) at the same time as coronary anatomy. The results derived from these scans will be compared to standard SPECT imaging.
To further evaluate obstruction in the coronary arteries, physicians may refer for an invasive Coronary Angiogram, the current gold standard for diagnosis of Coronary Artery Disease (CAD). By validating the DSCT scanner as a system with which to assess the extent of obstruction in the coronary arteries, physicians may be able to lessen the occurrence of an invasive exam.
Procedures: Each pilot anticipates enrolling 20 subjects.
Pilot 1: Clinical Follow-up Rest/Stress Adeno-SPECT and Research Stress /Rest Adeno-DSCT obtained in the same patient during the same period of stress testing
- Radiation: Thallium injection for rest SPECT
- Drug: Single dose Adenosine Infusion for DSCT and SPECT
- Radiation: Sestamibi injection for stress SPECT
- Drug: CT contrast
- Radiation: Stress DSCT /Rest DSCT
研究设计
- 研究类型
- Observational
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Provide written consent and are willing to comply with protocol requirements
- •Are at least 18 years of age
- •Are referred for clinically-ordered SPECT
- •Have known CAD
排除标准
- •Patients being referred to invasive coronary angiography will not be included in this pilot
- •Caffeine intake within the 24 hours prior to adenosine stress testing
- •Pregnancy (known or suspected)
- •Intolerance or contraindication to adenosine (severe Asthma...)
- •Intake of methylxanthine containing medications such as theophylline that have not been withdrawn and would interfere with the effectiveness of adenosine.
- •Unstable coronary syndromes
- •Uncontrolled congestive cardiac failure or cardiogenic shock
- •Uncontrolled hypertension with resting BP > 200/110
- •More than 30 days between the Adeno-SPECT and the Adeno-DSCT
- •Revascularization (percutaneous coronary intervention or coronary artery bypass graft surgery) between the Adeno-SPECT and the Adeno-DSCT
- •Change in clinical status as determined by the investigator
- •Inability to be on same medication regime 24 hrs prior to Adeno-SPECT and Adeno DSCT
- •Patients with chronic renal failure (C.C.T. < 60 ml/m2/sec)
- •Patients with allergy to contrast iodinated media
- •Congestive heart failure
- •History of thromboembolic disorders
- •Multiple myeloma
- •Hyperthyroidism
- •Pheochromocytoma
- •Atrial fibrillation
- •Inability to perform breath hold for 12 seconds
- •All inclusions/exclusions are the same as Pilot 1, WITH THE ADDITION OF:
- •Inclusion Criteria:
- •Have had prior (within 30 days) positive Adeno-SPECT scan
- •Exclusion Criteria:
- •Patients with contraindications to coronary angiography
结局指标
主要结局
To show that adenosine enhanced DSCT will enhance regular Multidetector Spiral Computed Tomography (MSCT) "diagnostic power" to detect significant (e.g., > 50%) coronary stenosis
时间窗: One day
次要结局
- To assess coronary anatomical results obtained by CT Angiography (CTA) at high heart rates in terms of the rate of assessable coronary segments.(One day)
研究者
Daniel S. Berman
Principal Investigator
Cedars-Sinai Medical Center