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Randomized Controlled Trial
. 2025 Jan 10;25(1):15.
doi: 10.1186/s12872-024-04437-2.

Reduced contrast agent volume using a heart-rate dependent and free-breathing scanning protocol in coronary computed tomography angiography (CTA) for patients with chronic obstructive pulmonary disease (COPD)

Zengkun Wang  1 , Guoyue Chen  2 , Dewei Song  3 , Xiaodie Xu  1 , Chu Chu  2 , Shuning Zhang  2 , Huijing Chai  2 , Hairong Yu  2 , Xiaomei Luan  1 , Peiji Song  4
Affiliations
Randomized Controlled Trial

Reduced contrast agent volume using a heart-rate dependent and free-breathing scanning protocol in coronary computed tomography angiography (CTA) for patients with chronic obstructive pulmonary disease (COPD)

Zengkun Wang et al. BMC Cardiovasc Disord. .

Abstract

Background: The personalized, free-breathing, heart rate-dependent computed tomography angiography (CTA) protocol can significantly reduce the utilization of contrast medium (CM). This proves especially beneficial for patients with chronic obstructive pulmonary disease (COPD) undergoing coronary artery CTA examinations.

Objective: The aim of this study was to evaluate the feasibility of a personalized CT scanning protocol that was tailored to patients' heart rate and free-breathing for coronary CTA of patients with COPD.

Methods: A total of 400 patients with COPD who need to undergo the coronary CTA were prospectively randomized into two groups (patients with vascular occlusion were excluded). Group A (n = 200) underwent CTA following a traditional protocol (70mL). The timing of the scans in Group B (n = 200) was determined according to the patient's HR and free-breathing (30mL).

Results: No difference was found between the two groups in the CT values of RCA, LA, or LCX; (p = 0.131, 0.195 and 0.116). Subjective ratings of image quality (Table 2) were not statistically different between the two groups (p = 0.825).

Conclusion: By adopting a heart-rate dependent and free-breathing protocol, the contrast medium volume were reduced in coronary CTA for patients with COPD, while the image quality was remained comparable to those acquired with routine CTA protocol.

Keywords: COPD; Coronary CTA; HR-based protocol; Low volume of contrast medium.

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Conflict of interest statement

Declarations. Ethical approval: This study was approved by the Ethics Committee of the Central Hospital Affiliated to Shandong First Medical University(approval number: JNCN2022-057, date of the approval: December in 2022), all methods were performed in accordance with the relevant guidelines and regulations. Informed consent: All participants provided written informed consent prior to enrollment. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Coronary CTA images of a patient of COPD receiving 30 mL of CM. (A-C) Axial CT images of LAD, LCX, RCA and associated CT values. (D) Three-dimensional volume-rendered reconstruction of coronary CTA. RCA: right coronary artery; LAD: left anterior descending artery; LCX: left circumflex artery
None
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