Diagnostic value of multislice computed tomography coronary angiography in patients with left bundle branch block

Antanas Jankauskas, Jurgita Zaveckienė, Ramūnas Unikas¹, Rimvydas Šlapikas¹, Algidas Basevičius, Remigijus Žaliūnas¹

Department of Radiology, ¹Department of Cardiology, Kaunas University of Medicine, Lithuania

Key words: coronary artery angiography; multislice computed tomography; diagnostic value; left bundle branch block.

Summary. Objective. The aim of present study was to evaluate the diagnostic value of multislice computed tomography coronary angiography in patients with left bundle branch block.

Materials and methods. Twenty-four patients who underwent both multislice computed tomography coronary angiography and invasive coronary angiography were enrolled in the study. Findings of these imaging modalities were compared in order to determine the sensitivity, specificity, positive predictive value, and negative predictive value of multislice computed tomography angiography in identifying hemodinamically significant stenoses (≥50%). All segments ≥2 mm in diameter were visually assessed independently from their degree of calcification and image quality.

Results. In total, 328 segments were analyzed. The Spearman correlation coefficient between multislice computed tomography and invasive coronary angiography was 0.76 (P<0.0001). On a per-segment basis, sensitivity, specificity, positive predictive value, and negative predictive value of multislice computed tomography angiography were 75%, 97.7%, 72%, and 98%, respectively; on a per-vessel basis, these values were 77.8%, 92.3%, 70%, and 94.7%, respectively; on a per-patient basis – 81.8%, 84.6%, 81.8%, and 84.6%, respectively.

Conclusions. Multislice computed tomography coronary angiography provides a high diagnostic accuracy in detecting significant coronary artery stenoses in patients with left bundle branch block.

Correspondence to A. Jankauskas, Department of Radiology, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: jankauskas.antanas@gmail.com

Received 9 June 2008, accepted 3 April 2009