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Comprehensive Cardiac CT Scans May Provide More Precise Image of Significant Heart Disease

By MedImaging International staff writers
Posted on 30 Sep 2009

A team of researchers and radiologists has developed a computed-tomography (CT)-based protocol that identifies both narrowing of coronary arteries and areas of myocardial ischemia, giving a better indication of clinically significant coronary artery disease.

The study was led by investigators from Massachusetts General Hospital (MGH; Boston, MA, USA) who reported their findings in the September 15, 2009, issue of the Journal of the American College of Cardiology. "This is among the first demonstrations of the use of cardiac CT to detect both coronary artery stenosis and resulting myocardial ischemia simultaneously in a single examination," stated Ricardo C. Cury, M.D., a cardiac imaging specialist at the MGH Heart Center and the study's lead investigator.

CT scanning uses conventional X-rays to produce cross-sectional images of anatomic structures and can detect plaques in coronary arteries. But the appearance of plaques on CT images may not indicate whether they actually compromise the heart muscle's blood supply. More detailed angiographic images obtained via invasive cardiac catheterization give a better picture of how obstructive a plaque may be, and perfusion studies utilizing technologies such as MRI scans or the nuclear medicine technologies single photon emission computed tomography (SPECT) and positron emission tomography (PET) reveal areas where limited blood flow has damaged the heart muscle, information that can determine whether a patient can be treated with drugs or requires surgical intervention.

Earlier studies showed that CT could identify areas of restricted coronary blood supply in resting individuals. The MGH-led study was designed to see whether a comprehensive cardiac CT examination could integrate myocardial perfusion studies in both resting and stress situations along with the anatomic data provided by CT angiography. The study enrolled 34 cardiac patients who recently had SPECT stress tests and were likely to also require angiography via cardiac catheterization.

Participants first had a cardiac CT taken while receiving an infusion of adenosine, which produces physiologic stress symptoms such as elevated heart rate and blood pressure. When vital signs returned to normal several minutes after the adenosine infusion, a resting cardiac CT was taken. Both of those scans involved the use of contrast material, and to detect areas with little or no contrast agent--indicating restrictions to the myocardial vasculature--a third CT scan was taken seven minutes later.

The accuracy of CT-based perfusion imaging in diagnosing coronary artery narrowing that considerably affected myocardial perfusion was virtually the same as SPECT stress imaging, and the results of coronary CT angiography also compared favorably to those of cardiac catheterization. Because the investigators used new radiation-dose-reduction techniques, the radiation dose of the three CT scans did not exceed the dosage involved in the SPECT stress perfusion study.

"While nuclear perfusion imaging provides information that can help guide patient treatment, it has limitations that can lead to either false-negative or false-positive findings," Dr. Cury explained. "The ability to acquire anatomical visualization of coronary artery stenosis together with physiological assessment of myocardial perfusion in a single study could improve diagnostic accuracy while potentially reducing costs and radiation exposure. Since our study was relatively small, we need to test this approach in a larger multicenter trial and further investigate the additional value of CT perfusion studies over CT angiography."

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64 (74.863433837891): select jos_twitters.link from jos_twitters where cat=10

65 (43.869018554688): select jos_facebook.link from jos_facebook where cat=10

66 (46.968460083008): select jos_google_plus.link from jos_google_plus where cat=10

67 (42.915344238281): select jos_linkedin.link from jos_linkedin where cat=10

68 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE id=294725604 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294725604 AND published='1' LIMIT 1

69 (49.114227294922): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (415.08674621582): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (312.08992004395): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1478.910446167): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (82.969665527344): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (70.095062255859): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (41.007995605469): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (39.815902709961): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (88.930130004883): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

105 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

106 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

109 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

110 (48.87580871582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (566.00570678711): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (818.01414489746): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (552.89268493652): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (169.99244689941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

115 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

116 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

117 (55.789947509766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

118 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

119 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

120 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

121 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

122 (442.0280456543): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 27956.962585449): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (748.1575012207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725604 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725604 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 7728.099822998): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (89.168548583984): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (331.16340637207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (51.021575927734): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (245.09429931641): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (197.8874206543): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (34.093856811523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (195.98007202148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (523.09036254883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (329.97131347656): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (200.98686218262): SELECT name FROM jos_deeppockets WHERE id=211

138 (33.855438232422): SELECT name FROM jos_deeppockets WHERE id=211

139 (553.84635925293): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (494.00329589844): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

142 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

143 (!!!!! 8895.8740234375): TRUNCATE TABLE jos_trademed_module

144 (159.02519226074): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (72.956085205078): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294725604 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (931.0245513916): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

149 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

150 (!!!!! 1639.1277313232): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

152 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

153 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294725604 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294725604 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (32.186508178711): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (69.141387939453): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (70.095062255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

158 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294725604 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294725604 AND published='1' LIMIT 1

159 (102.04315185547): select jos_twitters.link from jos_twitters where cat=10

160 (28.133392333984): select jos_facebook.link from jos_facebook where cat=10

161 (27.894973754883): select jos_google_plus.link from jos_google_plus where cat=10

162 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

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