64-MDCT angiography of the coronary arteries: nationwide survey of patient preparation practice.

摘要

OBJECTIVE: The purpose of this study was to evaluate the current practice of patient preparation for 64-MDCT angiography (CTA) of the coronary arteries. MATERIALS AND METHODS: Sites in the United States that perform 64-MDCT coronary angiography were surveyed by mail in 2006. Information requested included physician specialty; experience level; details about patient preparation, including the use, dose, route, and timing of premedication; and acceptable heart rate and rhythm. A total of 142 surveys were analyzed, with comparison of parameters across specialties (radiology, cardiology, or shared) and experience levels. RESULTS: All facets of the study (premedication, data acquisition, cardiac interpretation) are performed exclusively by radiologists in 49% of sites and by cardiologists in 14%. All sites administer beta-blockers. Target heart rate was reported as < or = 65 beats per minute (bpm) by 89% of responders. Despite most centers aiming for a heart rate of < or = 65 bpm, the maximum allowable heart rate is > 65 bpm in 80% of centers. Patients with arrhythmia are scanned in at least 25% of sites. Most sites (84%) administer nitroglycerin. Significant differences between specialties were noted for experience levels, timing and route of beta-blocker administration, and for target heart rate. The likelihood of scanning in the setting of arrhythmia and beta-blocker timing correlated with experience levels. CONCLUSION: These 64-MDCT coronary artery data from 2006 reveal consensus for a range of patient preparation parameters. Use of beta-blockers and nitroglycerin is routine, and the target heart rate is usually < or = 65 bpm. However, differences were noted for beta-blocker protocols and acceptable heart rate and rhythm, and some differences in practice are associated with experience level and specialty.