Coronary computed tomographic angiography (CCTA) is a noninvasive imaging tool for evaluation of the coronary arteries, with high sensitivity and high negative predictive value to exclude significant coronary artery disease (1). In the early days, effective radiation doses of up to 21 mSv have been reported for CCTA (2). Despite the recent advent of multidetector technologies allowing a better image quality and lower radiation doses, heart rate control by beta-blockers has remained key for improved cardiac image quality and radiation dose (3-5). Nevertheless, beta-blockers are...

1. Patients and study design are described in table 1 Study design Prospective Ethics Committee Approved Written informed consent All patients Inclusion criteria CCTA referral Exclusion criteria - < 18 years - Contraindications to X-ray exposure, Allergy to iodinated contrast agents - Mild to severe renal insufficiency (creatinine clearance < 60ml/min/1.73m² body surface area) Inclusion period June - July 2013 Table 1: Study design and cohort 2. Coronary CT acquisition protocol and image processing. All patients underwent the same imaging protocol using a 2nd generation...

208 consecutive and unselected patients were eligible. 8 were not included because of refusal (n =3), coronary bypass surgery (n = 3), and calcium channel blockade administration (n = 2). The remaining 200 patients (mean age 60±12, range 20-86 years; 92 females) were enrolled in this prospective study (Flowchart, figure 1); their clinical characteristics and cardiovascular risk factors are given in table 1, and in figures 2 and 3. 47 patients were receiving an oral beta-blocker as part of baseline medication, and 56 patients were...

In our study, the use of beta-blockers did not result into a significant difference in HR. Although HR remains a key determinant for image quality, it does not affect the effective radiation dose when using a 2nd generation 320-row scanner. Furthermore, HR cutoff with a 90% probability for good to excellent image quality in an “average” patient is sufficiently high (73 bpm) to obviate the need for HR control in most subjects, even though this cut-off may vary on a per-patient basis according to other...

1. Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of individuals undergoing invasive coronary angiography) trial.J Am Coll Cardiol. 2008;52:1724-32. 2. Mollet NR, Cademartiri F, van Mieghem CA, et al. High-resolution spiral computed tomography coronary angiography in patients reffered for diagnostic conventional coronary angiography.Circulation 2005;112:2318-23. 3. Cademartiri F, Maffei E, Arcadi...