Noninvasive diagnosis of coronary artery disease in patients with heart failure and systolic dysfunction of uncertain etiology, using late gadolinium-enhanced cardiovascular magnetic resonance

Soriano, Carlos J.; Ridocci, Francisco; Estornell, Jordi; Jiménez, Javier; Martínez, Vicente; Velasco, José A.

doi:10.1016/j.jacc.2004.11.037

Cited by 154 publications

(79 citation statements)

References 41 publications

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“…The absence of LGE in patients with severe coronary disease is an important finding. Previous publications predict that, in the absence of ischemic type scar on LGE-CMR, patients are unlikely to have significant coronary ischemia [16,17]. The present data suggest that absence of LGE does not equate to the absence of ischemia or significant coronary artery disease.…”

Section: Discussioncontrasting

confidence: 45%

“…The existence of patients with coronary disease and no LGE has been reported in previous studies. Soriano et al reported five patients with CAD but no enhancement, however, they had ''stenosis in nonproximal segments of the right coronary or left circumflex artery [which] would not explain the severity of the LV dysfunction'' [17]. McCrohen iCA invasive angiography, PPV positive predictive value, NPV negative predictive value, CCTA dual source coronary computed angiography, CMR-LGE cardiac magnetic resonance with late gadolinium enhancement imaging et al [16] reported that mid-wall enhancement was present in 28% of patients with DCM, but in no patients with ischemic LV dysfunction, leading to the common perception amongst the clinicians that mid-wall enhancement does not equate to an ischemic etiology.…”

Section: Discussionmentioning

confidence: 99%

“…LGE-CMR has been used to differentiate ischemic from non-ischemic cardiomyopathies through identification of typical ischemic-type scar [15][16][17]. However, absence of scar on LGE-CMR may not exclude an ischemic etiology of heart failure in the setting of global hibernation from 3-vessel or left main coronary artery disease [15].…”

Section: Introductionmentioning

confidence: 99%

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CT angiography with cardiac MRI: non-invasive functional and anatomical assessment for the etiology in newly diagnosed heart failure

Hamilton-Craig

Strugnell

Raffel

et al. 2011

Int J Cardiovasc Imaging

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Exclusion of ischemia is important in patients with newly diagnosed systolic heart failure (HF). We prospectively compared standard-of-care invasive catheter angiography (iCA) and echocardiography to a novel non-invasive strategy of both Coronary Computed Tomographic Angiography (CCTA) and Cardiovascular MRI (CMR) to determine the etiology of myocardial dysfunction Prospective data were collected from consecutive patients referred for iCA to investigate echocardiographically-confirmed new onset HF. CMR (1.5T GE) and dual source CCTA were performed within 2-7 days of iCA. Results were blinded and separately analyzed by expert readers. 426 coronary segments from 28 prospectively enrolled patients were analyzed by CCTA and quantitative iCA. The per-patient sensitivity and specificity of CCTA was 100% and 90%, respectively, negative predictive value (NPV) 100%, positive predictive value (PPV) 78%. Mean ejection fraction by CMR was 24%. Presence of ischemic-type LGE on CMR conferred a 67% sensitivity, 100% specificity, 90% NPV and 100% PPV. Combining CCTA with CMR conferred 100% specificity, 100% sensitivity, 100% PPV and 100% NPV for detection or exclusion of coronary disease. In patients with negative CCTA all invasive angiograms could have been avoided. In addition, two patients with no ischemic LGE by CMR had severe coronary disease on both CCTA and iCA, indicating global hibernation. This is a noteworthy finding in contrast to previous reports which suggested that absence of LGE rules out significant CAD. CCTA with CMR in newly-diagnosed HF enables non-invasive assessment of coronary artery disease, the severity and etiology of myocardial dysfunction and defines suitability for revascularization. Absence of ischemic-type LGE at CMR does not exclude CAD as a cause of LV dysfunction. A first-line strategy of functional and anatomic imaging with CMR and CCTA appears appropriate in newly diagnosed HF.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 99%

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CT angiography with cardiac MRI: non-invasive functional and anatomical assessment for the etiology in newly diagnosed heart failure

Hamilton-Craig

Strugnell

Raffel

et al. 2011

Int J Cardiovasc Imaging

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“…Previous reports have documented a significant positive correlation between the extent of subendocardial DCE and coronary stenoses, making this technique an excellent indicator of underlying significant CAD [18]. This has been reported also in patients without a clinical history of MI, but with angiographically documented coronary disease [19].…”

Section: Schlüsselwörtermentioning

confidence: 63%

Cardiac allograft vasculopathy

Bella

Minutoli

Coglitore

et al. 2010

Herz

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Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease affecting both intramyocardial and epicardial coronary arteries and is observed in patients during long-term survival after cardiac transplantation. We report a case of CAV complicated with silent transmural myocardial infarction and massive left ventricular thrombus formation associated with silent pericarditis and with ischemic and non-ischemic scar tissue, as detected by cardiac magnetic resonance imaging (CMRI). The authors suggest CMRI as an additional technique along with echocardiography during follow-up of heart transplant recipients. CMRI may contribute to the early identification of areas of myocardial wall abnormalities suggestive of CAV, thus guiding diagnosis and prompt percutaneous treatment.

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“…In the absence of this pattern, a cardiomyopathy is the more likely diagnosis. Using this simple algorithm, CMR has established a role in differentiating ischaemic from non-ischaemic cardiomyopathies and should be considered in the evaluation of the etiology of heart failure patients [13][14][15].…”

mentioning

confidence: 99%