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Nephrol Dial Transplant (2001) 16: 21-28
© 2001 European Renal Association-European Dialysis and Transplant Association

Invited Comment

Novel approaches to the non-invasive diagnosis of coronary-artery disease

Werner Moshage, Stephan Achenbach and Werner G. Daniel

Department of Internal Medicine II, University of Erlangen-Nürnberg, Erlangen, Germany

Keywords: computed tomography; coronary angiography; coronary artery disease; diagnosis; electron beam tomography; magnetic resonance imaging

Do we need novel approaches to the non-invasive diagnosis of coronary-artery disease?

The arsenal of non-invasive diagnostic tools for the workup of suspected coronary-artery disease seems well stocked: electrocardiography and echocardiography during rest and stress as well as nuclear cardiology are widely available. However, all of these techniques have an important limitation: they do not permit direct visualization and quantification of coronary-artery stenoses, but rather rely on the detection of functional consequences caused by flow-limiting lesions. Haemodynamically insignificant stenoses cannot be detected.

Cardiac catheterization with selective coronary angiography remains the gold standard for the assessment of the presence and severity of coronary-artery disease. This very frequently performed procedure, even though invasive, has a low procedure-related morbidity and mortality: severe adverse events such as acute myocardial infarction, stroke, or malignant arrhythmias are reported in less than 1%, death in less than 0.15% [1]. In the context of cardiac catheterization, intravascular ultrasound (IVUS) can be used to investigate precisely the coronary vessels . . . [Full Text of this Article]

Magnetic resonance imaging (MRI)

Electron-beam tomography (EBT)

Mechanical CT, helical CT, multirow helical CT

Conclusion and future prospects

Notes

References


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