CT in Cardiovascular Risk Stratification in Athletes: Optimization of the Study Protocol with 128-Slice CT and Experience at the PTA of Trani

Abstract

Cardiac computed tomography (CT) has emerged as a key tool in cardiovascular risk assessment, thanks to its ability to provide
morphological, functional, and tissue analysis in a non-invasive manner. This study examined the use of 128-slice cardiac CT to evaluate cardiovascular risk, with particular attention to the optimization of the retrospective ECG-gated protocol and the diag-
nostic image quality achieved at the PTA of Trani.
A total of 10 patients who underwent cardiac CT for various clinical reasons were included. The adoption of the retrospective
protocol allowed for continuous acquisition throughout the entire cardiac cycle, enabling both anatomical and functional assessments, such as ejection fraction and ventricular motion. Multiplanar reconstructions (MPR), maximum intensity projections (MIP), and volume renderings (VR) provided detailed analysis of the coronary arteries and any stenoses or anomalies in their course.
The Calcium Score (CACS) was calculated in all cases, proving to be an effective indicator for prognostic stratification in asymptomatic or intermediate-risk subjects. Stable calcified plaques and significant stenoses were found in patients with high CACS values (>400), whereas lower scores were associated with normal angiographic findings. The results confirm that 128-slice cardiac CT is a reliable and reproducible tool for cardiovascular risk evaluation, enabling early diagnosis and improved clinical management. This experience also highlights the potential use of this technique in cardiovascular screening of athletes, where distinguishing between physiological adaptation and pathology is crucial to ensure safety in sports participation