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Aim To investigate the diagnostic accuracy of dual-source computed tomography (DSCT) coronary angiography with and without the application of a β-blocker. Materials and methods An exact binomial rendition of the bivariate mixed-effects regression model was used to synthesize diagnostic test data. Results The pooled sensitivity at the patient level was 0.98 [95% confidence intervals (CI): 0.97–0.99], and specificity 0.88 (95% CI: 0.84–0.91). The results showed that without heart rate control, the sensitivity and specificity at the patient level did not decrease ( p = 0.27 and 0.56, respectively). At the artery level, no significant differences in sensitivity and specificity for studies with and without heart rate control were detected ( p = 0.04 and 0.05, respectively). At the segment level, the specificity decreased without heart rate control ( p = 0.03), whereas the sensitivity was not influenced ( p = 0.63). The median radiation exposure was 2.6 mSv, with 1.6 mSv and 8 mSv for heart rate-controlled studies and uncontrolled studies, respectively. Conclusions DSCT coronary angiography without heart rate control has a similar excellent diagnostic performance at the patient level as that of heart rate control groups. However, controlling for heart rate to decrease radiation and to provide effective information for selecting the therapeutic strategy and risk stratification is recommended.

Aim To investigate the optimal pattern of systolic and diastolic reconstruction windows for coronary computed tomography (CT) angiography using 320-detector rows dynamic volume CT (DVCT). Material and methods A prospective analysis was performed on the data from 77 patients who were admitted between December 2008 and July 2009 for DVCT. The images were reconstructed in 10% steps throughout the 10–100% of R–R interval. Data sets for the three major coronary arteries [right coronary artery (RCA), left anterior descending artery (LAD), and left circumflex artery (LCX)] were evaluated by two independent readers. The quality of the images from each examined artery was graded from 1 (no motion artefacts) to 4 (severe motion artefacts over the entire vessel). The optimal systolic and diastolic reconstruction windows and the relationship between image quality and heart rate (HR) were analysed. The HR at which the optimal reconstruction window shifted from diastole to systole was predicted. Results The average HR during imaging was 69.5 ± 12.8 beats/min (range 46–102 beats/min). HR was positively correlated with the proportion of systole (r = 0.78, p