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Prognostic Implications of Dipyridamole Cardiac MR Imaging: A Prospective Multicenter Registry.
MedLine Citation:
PMID:  22084203     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:To evaluate dipyridamole cardiac magnetic resonance (MR) imaging in the prediction of major events (MEs) in patients with ischemic chest pain in a large multicenter registry.Materials and Methods:Institutional ethics committee approval and written informed consent were obtained. A total of 1722 patients who were undergoing cardiac MR imaging for chest pain were included. Wall motion abnormalities (WMAs) at rest, hyperemia perfusion defect (PD), late gadolinium enhancement (LGE), and inducible WMA were analyzed (abnormal if more than one abnormal segment was seen) with the 17-segment model. A cardiac MR categorization was created: category 1, no PD, LGE, or inducible WMA; category 2, PD without LGE and inducible WMA; category 3, LGE without inducible WMA; and category 4, inducible WMA. The association with ME was analyzed by using Cox proportional hazard regression multivariate models.Results:During a median follow-up period of 308 days, 61 MEs (4%) occurred (36 cardiac deaths, 25 nonfatal myocardial infarctions). MEs were associated with a greater extent of WMA, PD, LGE, and inducible WMA (P ≤ .001 for all analyses). In multivariable analyses, PD (P = .002) and inducible WMA (P = .0001) were the only cardiac MR predictors. ME rate in categories 1, 2, 3, and 4 was 2% (14 of 901 patients), 3% (six of 219 patients), 4% (15 of 409 patients), and 14% (26 of 193 patients), respectively (category 4 vs category 1, adjusted P < .001). Cardiac MR-directed revascularization was performed in 242 patients (14%) and reduced the risk of ME in only category 4 (7% [six of 92 patients] vs 26% [26 of 101 patients], P = .0004).Conclusion:Dipyridamole cardiac MR imaging can be used to predict MEs in patients with ischemic chest pain. Patients with inducible WMA are at the highest risk for MEs and benefit the most from revascularization.© RSNA, 2011Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110134/-/DC1.
Authors:
Vicente Bodi; Oliver Husser; Juan Sanchis; Julio Núñez; José V Monmeneu; María P López-Lereu; María J Bosch; Eva Rumiz; Gema Miñana; Carlos García; José L Diago; Fabián Chaustre; David Moratal; Cristina Gómez; José Aguilar; Francisco J Chorro; Angel Llacer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-14
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Cardiology, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibáñez 17, Valencia 46010, Spain; ERESA, Valencia, Spain; Cardiology Unit, Hospital La Plana, Vila-real, Spain; Department of Cardiology, Hospital General, Castellon, Spain.
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