Document Detail


Comparison of quantitative coronary angiography and first-pass perfusion magnetic resonance imaging for the detection of an impaired coronary perfusion in nonsevere coronary stenosis.
MedLine Citation:
PMID:  18425839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare quantitative coronary angiography (QCA) and first-pass perfusion magnetic resonance imaging (FPP-MRI) in symptomatic patients with nonsevere coronary stenosis to detect a reduced coronary flow velocity reserve (CFVR). MATERIALS AND METHODS: In 35 patients, FPP-MRI and CFVR measurements were performed in 40 coronary arteries with a diameter stenosis (DS) <70% by QCA. From FPP-MRI a myocardial perfusion reserve index (MPRI) was calculated. CFVR was calculated as the ratio of the average peak flow velocity during infusion of adenosine and at rest and was considered reduced if <2. Diagnostic performance of MPRI and DS to detect a reduced CFVR was compared by receiver operating characteristic (ROC) curve analysis. RESULTS: CFVR was reduced in 16 coronary arteries (40%). Mean DS did not differ in coronary arteries with a reduced CFVR (41.0% +/- 13.3) and a normal CFVR (36.5% +/- 12.3; P = 0.281). Mean MPRI was lower in coronary arteries with a reduced CFVR (1.12 +/- 0.12) compared to a normal CFVR (1.33 +/- 0.2; P < 0.001). Sensitivity, specificity, and area under the ROC curve (AUC) were higher for MPRI (81%, 79%, 0.84) than for DS (56%, 58%, 0.60). CONCLUSION: FPP-MRI detects impaired CFVR in symptomatic patients with nonsevere coronary stenosis more accurately than QCA and can identify patients with symptomatic ischemia.
Authors:
Achim A Barmeyer; Alexander Stork; Kai Muellerleile; Anne K Schofer; Claudia Tiburtius; Ralf Koester; Thomas Heitzer; Gerhard Adam; Thomas Meinertz; Gunnar K Lund
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of magnetic resonance imaging : JMRI     Volume:  27     ISSN:  1053-1807     ISO Abbreviation:  J Magn Reson Imaging     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-28     Completed Date:  2008-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105850     Medline TA:  J Magn Reson Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1005-11     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Department of Cardiology/Angiology, Center for Cardiology and Cardiovascular Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany. barmeyer@uke.uni-hamburg.de
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage
Analysis of Variance
Blood Flow Velocity
Contrast Media / administration & dosage
Coronary Angiography / methods*
Coronary Stenosis / physiopathology*
Female
Fractional Flow Reserve, Myocardial*
Humans
Magnetic Resonance Imaging / methods*
Male
Meglumine / administration & dosage,  analogs & derivatives
Middle Aged
Organometallic Compounds / administration & dosage
ROC Curve
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 113662-23-0/gadobenic acid; 58-61-7/Adenosine; 6284-40-8/Meglumine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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