Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease

Kiaos, Apostolos; Tziatzios, Ioannis; Hadjimiltiades, Stavros; Karvounis, Charalambos; Karamitsos, Theodoros D.

doi:10.1016/j.ijcard.2017.11.066

Cited by 36 publications

(25 citation statements)

References 25 publications

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“…The choice of the two imaging modalities 3D-PERF and 3D-SCAR seems reasonable. Regarding myocardial perfusion deficits, cardiac MR adenosine stress imaging was found to be highly valuable in diagnostics 26,27 and prognostic risk stratification. 28,29 For myocardial scar, LGE was found to be the best marker of prognosis in stable CAD 30 and to best predict clinical impact following cardiac MR. 31 It was shown that the combination of adenosine stress perfusion and LGE imaging offers complementary prognostic value.…”

Section: Discussionmentioning

confidence: 99%

3D image fusion of whole‐heart dynamic cardiac MR perfusion and late gadolinium enhancement: Intuitive delineation of myocardial hypoperfusion and scar

Spiczak

Mannil

Kozerke

et al. 2018

Magnetic Resonance Imaging

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Section: Discussionmentioning

confidence: 99%

3D image fusion of whole‐heart dynamic cardiac MR perfusion and late gadolinium enhancement: Intuitive delineation of myocardial hypoperfusion and scar

Spiczak

Mannil

Kozerke

et al. 2018

Magnetic Resonance Imaging

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“…Detecting the true extent of myocardial ischemia is not only of diagnostic but also of prognostic value [25]. Hence, in order to preserve the high diagnostic accuracy of adenosine stress perfusion CMR [1], we still suggest to refrain from caffeine intake prior adenosine stress CMR exams.…”

Section: Semiquantitative Perfusion Analysis -Entire Myocardium and Mmentioning

confidence: 99%

“…Adenosine stress cardiovascular magnetic resonance (CMR) is a routine diagnostic tool in the assessment of ischemia in patients with known or suspected coronary artery disease (CAD) [1]. In clinical routine, physicians often encounter patients who report recent caffeine consumption despite instructions to avoid caffeine 24 h before the exam.…”

Section: Introductionmentioning

confidence: 99%

Impact of caffeine on myocardial perfusion reserve assessed by semiquantitative adenosine stress perfusion cardiovascular magnetic resonance

Seitz

Kaesemann

Chatzitofi

et al. 2019

Journal of Cardiovascular Magnetic Resonance

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Background: Adenosine is used in stress perfusion cardiac imaging to reveal myocardial ischemia by its vasodilator effects. Caffeine is a competitive antagonist of adenosine. However, previous studies reported inconsistent results about the influence of caffeine on adenosine's vasodilator effect. This study assessed the impact of caffeine on the myocardial perfusion reserve index (MPRI) using adenosine stress cardiovascular magnetic resonance imaging (CMR). Moreover, we sought to evaluate if the splenic switch-off sign might be indicative of prior caffeine consumption. Methods: Semiquantitative perfusion analysis was performed in 25 patients who underwent: 1) caffeine-naïve adenosine stress CMR demonstrating myocardial ischemia and, 2) repeat adenosine stress CMR after intake of caffeine. MPRI (global; remote and ischemic segments), and splenic perfusion ratio (SPR) were assessed and compared between both exams. Results: Global MPRI after caffeine was lower vs. caffeine-naïve conditions (1.09 ± 0.19 vs. 1.24 ± 0.19; p < 0.01). MPRI in remote myocardium decreased by caffeine (1.24 ± 0.19 vs. 1.49 ± 0.19; p < 0.001) whereas MPRI in ischemic segments (0.89 ± 0.18 vs. 0.95 ± 0.23; p = 0.23) was similar, resulting in a lower MPRI ratio (=remote/ischemic segments) after caffeine consumption vs. caffeine-naïve conditions (1.41 ± 0.19 vs. 1.64 ± 0.35, p = 0.01). The SPR was unaffected by caffeine (SPR 0.38 ± 0.19 vs. 0.38 ± 0.18; p = 0.92). Conclusion: Caffeine consumption prior to adenosine stress CMR results in a lower global MPRI, which is driven by the decreased MPRI in remote myocardium and underlines the need of abstinence from caffeine. The splenic switch-off sign is not affected by prior caffeine intake.

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“…[32][33][34] Unfortunately, no study has yet reported on the incremental comparative accuracy of such hybrid imaging in comparison to invasive assessments, even if reports using CT-FFR as gold standard are already available. 35 Cardiac magnetic resonance has gained significant ground in the comprehensive anatomic and functional assessment of cardiovascular disease. In the diagnosis of CAD, CMR, incorporating the administration of a pharmacologic stressor and gadolinium-chelate contrast, has proven as a valuable non-invasive alternative to ICA and FFR, with sensitivity and specificity of 90% and 77%, and of 90% and 85%, respectively.…”

Section: Hybrid Imagingmentioning

confidence: 99%

“…In the diagnosis of CAD, CMR, incorporating the administration of a pharmacologic stressor and gadolinium-chelate contrast, has proven as a valuable non-invasive alternative to ICA and FFR, with sensitivity and specificity of 90% and 77%, and of 90% and 85%, respectively. 35 Several studies have appraised the benefit of combined imaging with CMR and CTA, finding that CMR/CTA has in comparison to ICA a sensitivity ranging between 88% and 99% and a specificity ranging between 87% and 100%. 10,36,37 Similarly favorable results have been reported in comparison to FFR, with sensitivity of 85% and specificity of 94%.…”

Section: Hybrid Imagingmentioning

confidence: 99%

Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components

Nudi

Biondi‐Zoccai

Romagnoli

et al. 2019

Journal of Nuclear Cardiology

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Coronary artery disease (CAD) is the most common and important cause of ischemic heart disease, with major implications on global morbidity and mortality. Non-invasive testing is crucial in the diagnostic and prognostic work-up of patients with or at risk of CAD, and also to guide decision making in terms of pharmacologic and revascularization therapy. The traditional paradigm is to view anatomic (i.e., coronary computed tomography) and functional imaging (e.g., myocardial perfusion scintigraphy) tests as opposing alternatives. Such approach is too reductionist and does not capitalize on the strengths of each type of test while risking to overlook the inherent limitations. The combination of anatomic and functional tests in a logic of hybrid imaging holds the promise of overcoming the limitations inherent to anatomic and functional testing, enabling more accurate diagnosis, prognosis, and guidance for revascularization in patients with CAD.

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Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease

Cited by 36 publications

References 25 publications

3D image fusion of whole‐heart dynamic cardiac MR perfusion and late gadolinium enhancement: Intuitive delineation of myocardial hypoperfusion and scar

3D image fusion of whole‐heart dynamic cardiac MR perfusion and late gadolinium enhancement: Intuitive delineation of myocardial hypoperfusion and scar

Impact of caffeine on myocardial perfusion reserve assessed by semiquantitative adenosine stress perfusion cardiovascular magnetic resonance

Hybrid anatomo-functional imaging of coronary artery disease: Beneficial irrespective of its core components

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