Cardiac magnetic resonance myocardial perfusion imaging for detection of functionally significant obstructive coronary artery disease: A prospective study

• Type: Article in International Scientific Journal
• Date: 2013

Authors

Bettencourt, N (Author) Other; Chiribiri, A (Author) Other; Schuster, A (Author) Other; Ferreira, N (Author) Other; Sampaio, F (Author) Other; Duarte, R (Author) Other; Santos, L (Author) Other; Melica, B (Author) Other; Rodrigues, A (Author) Other; Braga, P (Author) Other; Teixeira, M (Author) Other; Simoes, L (Author) Other; Leite-Moreira AF (Author) FMUP; Silva Cardoso, J (Author) FMUP; Nagel, E (Author) Other; Portugal, P (Author) Other; Gama, V (Author) Other

Journal

Title: International Journal of Cardiology

Vol. 168

Pages: 765-773

ISSN: 0167-5273

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 28 Citations

Scopus - 31 Citations

Other information

Authenticus ID: P-006-77A

DOI: 10.1016/j.ijcard.2012.09.231

Abstract (EN): Background: Cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI) is considered a state of the art non-invasive modality for the detection of reversible ischemia. Recent studies have shown its utility in the diagnosis of coronary artery disease (CAD) and superiority over other established techniques. However, only a few studies compared CMR-MPI against the invasive standard including fractional flow reserve (FFR) and clinical validation in non-specialized centers is scarce. The aim of this study was to validate CMR-MPI in a real-world clinical environment and to test its diagnostic accuracy in symptomatic patients with suspected CAD versus FFR as the reference standard of functionally significant disease. Methods and results: 103 symptomatic consecutive patients (62 +/- 8.0 years, 66% males) with suspected CAD and intermediate or high probability of disease underwent sequential CMR and invasive coronary angiography (XA). The CMR protocol included stress-rest adenosine perfusion, SSFP cine imaging and late-enhancement imaging. Functionally significant CAD was defined as occlusive/sub-occlusive stenoses on XA or non-occlusive stenoses with a FFR measurement of <0.80 in vessels >2 mm. On a patient-based model, CMR-MPI had sensitivity, specificity, positive and negative predictive values of 89%, 88%, 85%, and 91%, respectively, with a global accuracy of 88%. On a vessel-based analysis, these values were 80%, 93%, 79% and 94%, respectively, with a global accuracy of 90%. Conclusions: CMR-MPI had a very high accuracy for detection of functionally significant CAD as assessed by FFR in patients with intermediate to high pretest probability.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9