Coronary Artery Motion and Cardiac Phases: Dependency on Heart Rate—Implications for CT Image Reconstruction

This study had institutional review board approval; written informed consent was obtained. The purpose was to prospectively determine the heart rate (HR) dependency of three-dimensional (3D) coronary artery motion by incorporating into analysis the durations of systole and diastole. Thirty patients (seven women, 23 men; mean age, 56.6 years ± 12.7 [standard deviation]; HR: 45–100 beats per minute) underwent electrocardiographically gated 64-section computed tomographic (CT) coronary angiography to determine coronary motion velocities at bifurcation points. Significance of velocity differences (P < .05) was determined by using analysis of variance for repeated measures and Bonferroni post hoc tests. HR dependency was determined by using linear regression analysis. HR significantly affected 3D coronary motion (r = 0.47, P < .009) through nonproportional shortening of systole and diastole (r = −0.82, P < .001), leading to percentage reconstruction interval shifts of coronary velocity troughs and peaks (P < .01). Results suggest that image reconstruction algorithms at CT coronary angiography be adapted to the individual patient's HR.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2451061791/DC1

© RSNA, 2007

References

  • 1 Ding Z, Friedman MH. Quantification of 3-D coronary arterial motion using clinical biplane cineangiograms. Int J Card Imaging 2000; 16: 331–346.
  • 2 Ritchie CJ, Godwin JD, Crawford CR, Stanford W, Anno H, Kim Y. Minimum scan speeds for suppression of motion artifacts in CT. Radiology 1992;185:37–42.
  • 3 Kong Y, Morris JJ Jr, McIntosh HD. Assessment of regional myocardial performance from biplane coronary cineangiograms. Am J Cardiol 1971;27:529–537.
  • 4 Potel MJ, Rubin JM, MacKay SA, Aisen AM, Al-Sadir J, Sayre RE. Methods for evaluating cardiac wall motion in three dimensions using bifurcation points of the coronary arterial tree. Invest Radiol 1983;18:47–57.
  • 5 Johnson KR, Patel SJ, Whigham A, Hakim A, Pettigrew RI, Oshinski JN. Three-dimensional, time-resolved motion of the coronary arteries. J Cardiovasc Magn Reson 2004;6:663–673.
  • 6 Achenbach S, Ropers D, Holle J, Muschiol G, Daniel WG, Moshage W. In-plane coronary arterial motion velocity: measurement with electron-beam CT. Radiology 2000;216:457–463.
  • 7 Mao S, Lu B, Oudiz RJ, Bakhsheshi H, Liu SC, Budoff MJ. Coronary artery motion in electron beam tomography. J Comput Assist Tomogr 2000;24:253–258.
  • 8 Lu B, Mao SS, Zhuang N, et al. Coronary artery motion during the cardiac cycle and optimal ECG triggering for coronary artery imaging. Invest Radiol 2001;36:250–256.
  • 9 Hofman MB, Wickline SA, Lorenz CH. Quantification of in-plane motion of the coronary arteries during the cardiac cycle: implications for acquisition window duration for MR flow quantification. J Magn Reson Imaging 1998;8:568–576.
  • 10 Saranathan M, Ho VB, Hood MN, Foo TK, Hardy CJ. Adaptive vessel tracking: automated computation of vessel trajectories for improved efficiency in 2D coronary MR angiography. J Magn Reson Imaging 2001;14:368–373.
  • 11 Vembar M, Garcia MJ, Heuscher DJ, et al. A dynamic approach to identifying desired physiological phases for cardiac imaging using multislice spiral CT. Med Phys 2003;30:1683–1693.
  • 12 Vembar M, Walker MJ, Johnson PC. Cardiac imaging using multislice computed tomography scanners: technical considerations. Coron Artery Dis 2006;17:115–123.
  • 13 Manzke R, Kohler T, Nielsen T, Hawkes D, Grass M. Automatic phase determination for retrospectively gated cardiac CT. Med Phys 2004;31:3345–3362.
  • 14 Leschka S, Wildermuth S, Boehm T, et al. Noninvasive coronary angiography with 64-section CT: effect of average heart rate and heart rate variability on image quality. Radiology 2006;241:378–385.
  • 15 Leschka S, Husmann L, Desbiolles LM, et al. Optimal image reconstruction intervals for non-invasive coronary angiography with 64-slice CT. Eur Radiol 2006;16:1964–1972.
  • 16 Kovacs SJ Jr. The duration of the QT interval as a function of heart rate: a derivation based on physical principles and a comparison to measured values. Am Heart J 1985;110:872–878.
  • 17 Chung CS, Karamanoglu M, Kovacs SJ. Duration of diastole and its phases as a function of heart rate during supine bicycle exercise. Am J Physiol Heart Circ Physiol 2004;287:H2003–H2008.
  • 18 Hoffmann MH, Shi H, Manzke R, et al. Noninvasive coronary angiography with 16-detector row CT: effect of heart rate. Radiology 2005;234:86–97.
  • 19 Herzog C, Arning-Erb M, Zangos S, et al. Multi-detector row CT coronary angiography: influence of reconstruction technique and heart rate on image quality. Radiology 2006;238:75–86.
  • 20 Flohr T, Ohnesorge B. Heart rate adaptive optimization of spatial and temporal resolution for electrocardiogram-gated multislice spiral CT of the heart. J Comput Assist Tomogr 2001;25:907–923.
  • 21 Wiggers C. Studies of the consecutive phases of the cardiac cycle. I. The duration of the consecutive phases of the cardiac cycle and the criteria for their precise determination. Am J Physiol 1921;56:415–438.
  • 22 Luisada AA, MacCanon DM. The phases of the cardiac cycle. Am Heart J 1972;83:705–711.
  • 23 Baumert B, Plass A, Bettex D, et al. Dynamic cine mode imaging of the normal aortic valve using 16-channel multidetector row computed tomography. Invest Radiol 2005;40:637–647.
  • 24 Austen WG, Edwards JE, Frye RL, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 1975;51:5–40.
  • 25 Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960;20:37–46.
  • 26 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174.
  • 27 Heid IM, Kuchenhoff H, Wellmann J, Gerken M, Kreienbrock L, Wichmann HE. On the potential of measurement error to induce differential bias on odds ratio estimates: an example from radon epidemiology. Stat Med 2002;21:3261–3278.
  • 28 Flohr TG, Stierstorfer K, Ulzheimer S, Bruder H, Primak AN, McCollough CH. Image reconstruction and image quality evaluation for a 64-slice CT scanner with z-flying focal spot. Med Phys 2005;32:2536–2547.
  • 29 Leschka S, Alkadhi H, Plass A, et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 2005;26:1482–1487.
  • 30 Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005;46:552–557.
  • 31 Leber AW, Knez A, von Ziegler F, et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 2005;46:147–154.
  • 32 Wintersperger BJ, Nikolaou K, von Ziegler F, et al. Image quality, motion artifacts, and reconstruction timing of 64-slice coronary computed tomography angiography with 0.33-second rotation speed. Invest Radiol 2006;41:436–442.
  • 33 Jakobs TF, Becker CR, Ohnesorge B, et al. Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 2002;12:1081–1086.
  • 34 Ding Z, Friedman MH. Dynamics of human coronary arterial motion and its potential role in coronary atherogenesis. J Biomech Eng 2000;122:488–492.
  • 35 Duerinckx A, Atkinson DP. Coronary MR angiography during peak-systole: work in progress. J Magn Reson Imaging 1997;7:979–986.

Article History

Published in print: 2007