| Improved detection of coronary artery disease by stress perfusion cardiovascular magnetic resonance with the use of delayed enhancement infarction imaging. | |
| | |
MedLine Citation:
|
PMID: 16631001 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We tested a pre-defined visual interpretation algorithm that combines cardiovascular magnetic resonance (CMR) data from perfusion and infarction imaging for the diagnosis of coronary artery disease (CAD). BACKGROUND: Cardiovascular magnetic resonance can assess both myocardial perfusion and infarction with independent techniques in a single session. METHODS: We prospectively enrolled 100 consecutive patients with suspected CAD scheduled for X-ray coronary angiography. Patients had comprehensive clinical evaluation, including Rose angina questionnaire, 12-lead electrocardiography, C-reactive protein, and calculation of Framingham risk. Cardiovascular magnetic resonance included cine, adenosine-stress and rest perfusion-CMR, and delayed enhancement-CMR (DE-CMR) for infarction imaging. Matched stress-rest perfusion defects in the absence of infarction by DE-CMR were considered artifactual. All patients underwent X-ray angiography within 24 h of CMR. RESULTS: Ninety-two patients had complete CMR examinations. Significant CAD (> or =70% stenosis) was found in 37 patients (40%). The combination of perfusion and DE-CMR had a sensitivity, specificity, and accuracy of 89%, 87%, and 88%, respectively, for CAD diagnosis, compared with 84%, 58%, and 68%, respectively, for perfusion-CMR alone. The combination had higher specificity and accuracy (p < 0.0001), owing to incorporating the exceptionally high specificity (98%) of DE-CMR. Receiver operating characteristic curve analysis demonstrated the combination provided better performance than cine, perfusion, or DE-CMR alone. The accuracy was high in single-vessel and multivessel disease and independent of CAD location. Multivariable analysis including standard clinical parameters demonstrated the combination was the strongest independent CAD predictor. CONCLUSIONS: A combined perfusion and infarction CMR examination with a visual interpretation algorithm can accurately diagnose CAD in the clinical setting. The combination is superior to perfusion-CMR alone. |
| | |
Authors:
|
Igor Klem; John F Heitner; Dipan J Shah; Michael H Sketch; Victor Behar; Jonathan Weinsaft; Peter Cawley; Michele Parker; Michael Elliott; Robert M Judd; Raymond J Kim |
Publication Detail:
|
Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural Date: 2006-03-27 |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 47 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Apr |
Date Detail:
|
Created Date: 2006-04-24 Completed Date: 2006-05-17 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 1630-8 Citation Subset: AIM; IM |
Affiliation:
|
Duke Cardiovascular Magnetic Resonance Center, Durham, North Carolina, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Algorithms Cardiovascular System / pathology* Coronary Artery Disease / diagnosis* Exercise Test* Female Humans Image Enhancement* Magnetic Resonance Angiography* Male Middle Aged Myocardial Infarction / diagnosis* Predictive Value of Tests Prospective Studies Time Factors |
| Grant Support | |
ID/Acronym/Agency:
|
K02-HL04394/HL/NHLBI NIH HHS; R01-HL63268/HL/NHLBI NIH HHS; R01-HL64726/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
|
Nat Clin Pract Cardiovasc Med. 2006 Sep;3(9):472-3
[PMID:
16932760
]
J Am Coll Cardiol. 2006 Apr 18;47(8):1639-40 [PMID: 16631002 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary endothelial vasomotor function and vascular remodeling in heart transplant recipients rando...
Next Document: Reproducibility of chronic and acute infarct size measurement by delayed enhancement-magnetic resona...