Why radiologists must carefully evaluate patient heart rates prior to coronary CTA exams
Heart rate has a significant influence on image quality during coronary CT angiography exams, according to new research. Radiologists and other providers must carefully assess patients to ensure optimal scan quality.
So says a group of seven imaging and cardiology experts in a research letter published Tuesday in Radiology. The findings come from a sub-analysis of nearly 2,000 patients taken from the PROTECTION VI study, which assessed CCTA radiation dose numbers in daily practice across nearly 60 separate centers.
“The results suggest that cardiologists and radiologists should aim for a lower patient heart rate to obtain the best image quality and simultaneously allow for lower radiation dose in coronary CTA imaging,” Thomas J. Stocker, of the German Center for Cardiovascular Research in Munich, and co-authors urged.
Specifically, they recommend using beta blockers to control patients’ heart rates, especially for those topping 75 beats per minute. Careful consideration should be given to patients with rates between 60 and 75 beats per minute.
These findings were confirmed in multiple scanner types and imaging protocols used across 57 healthcare sites worldwide.
Coronary CTA is an established first-line test for suspected coronary artery disease and many improvements have been made to limit radiation exposure while maintaining image quality. But as the world’s population ages, CAD cases and CCTA exams will increase, a pair of radiologists wrote in an editorial accompanying the June 15 research letter.
Joseph Schoepf, MD, with the Medical University of South Carolina and Josua Decker of University Hospital Augsburg in Germany both underscored that careful patient monitoring will be required going forward.
“The study by Stocker and colleagues has real-world results that show that even with our modern high-resolution CT scanners, heart rate significantly influences diagnostic quality and radiation dose of coronary CTA,” the pair added Tuesday. “Given these results, the heart rate of every patient should be carefully evaluated prior to the examination.”
Read the full research letter here and the entire editorial here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.