Diagnostic accuracy of coronary computed tomography angiography in ischemic workup of heart failure: a meta-analysis

Future Cardiol. 2022 Apr;18(4):325-335. doi: 10.2217/fca-2021-0108. Epub 2022 Feb 4.

Abstract

Aim: The role of coronary computed tomography angiography (CCTA) in evaluating the etiology of heart failure with reduced ejection fraction (HFrEF) is unclear. This is a meta-analysis assessing the pooled diagnostic accuracy of CCTA in diagnosing significant coronary artery disease in HFrEF. Materials & methods: Electronic databases were searched for studies comparing CCTA with invasive coronary angiography in HFrEF. A random-effects model meta-analysis was conducted. Results: Five studies comprising 269 patients were included. On patient-based analysis, pooled sensitivity and specificity of CCTA were 0.99 (95% CI: 0.94-1.00) and 0.94 (95% CI: 0.90-0.97), respectively. On segment-based analysis, pooled sensitivity and specificity were 0.74 (95% CI: 0.67-0.80) and 0.99 (95% CI: 0.98-0.99), respectively. Conclusion: CCTA has excellent diagnostic accuracy in diagnosing significant coronary artery disease in newly diagnosed HFrEF.

Keywords: coronary angiography; coronary artery disease; coronary computed tomography angiography; heart failure; ischemic cardiomyopathy.

Plain language summary

The role of ‘CAT scan,’ a computerized series of x-rays, in determining the cause of heart failure with low pumping capacity of the heart is unclear. We conducted a study to assess the accuracy of CAT scan in diagnosing significant blockage of blood vessels supplying the heart muscle. We searched electronic databases for studies comparing the accuracy of CAT scan with another procedure that injects a special dye into blood vessels to visualize blockage of the blood vessels supplying the heart muscle, specifically in patients with heart failure. On statistically analysis, CAT scan was found to be highly accurate in diagnosing significant blockage of these blood vessels in patients with heart failure.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Computed Tomography Angiography / methods
  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Heart Failure* / diagnostic imaging
  • Humans
  • Stroke Volume