Perfusion cardiovascular magnetic resonance as the first-line technique in patients with stable chest pain

Gawor, Monika; Nagel, Eike

doi:10.33963/kp.15204

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…318 events were registered in the ICA group vs. 352 events in the OMT group. The event rates were 5.3% vs. 3.4% (ICA vs. OMT groups) at 6 months, and 16.4% vs. 18.2% at 5 years with no benefit in term of reduction of mortality or myocardial infarction in the ICA group (52,53). However, the OMT group was not fully conservative because 23% of patients underwent ICA with revascularization.…”

Section: Breakthrough Of Cct In the Clinical Scenariomentioning

confidence: 95%

Updated diagnostic & prognostic paradigm for CAD: a narrative review

Toia¹,

Grutta²,

Smeraldi³

et al. 2020

Cardiovasc Diagn Ther

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Cardiovascular diseases are the first cause of death globally; early detection of coronary artery disease (CAD) is a challenge for clinicians and radiologists. Over the past 2 decades there have been several improvements in the methods for the assessment of diagnosis and prognosis in patients with suspected CAD; most of these methods are imaging methods and they operate with high-end technologies. Cardiac computed tomography (CCT) as we know it today was introduced in 1998 and has ever progressed with constant pace. The first decade was the technical validation phase of the method while the second decade was the clinical validation phase. CCT has developed an excellent diagnostic and prognostic value; technological development together with radiation dose reduction, contributed to the widening of its clinical indications.The diagnostic value of CCT is particularly important as a first line in symptomatic patients with suspected obstructive CAD and low-to-intermediate cardiovascular risk. It is a test that should come, whenever possible, in front of functional evaluation because of its very high sensitivity and negative predictive value.The prognostic value of CCt is still investigational, even though it is becoming quite evident that the atherosclerotic phenotype plays a major role in the determination of prognosis, and as consequence, in the individualization of optimal pharmacological therapy, especially in the cohort without significant obstructive CAD. Recently, scientific and practical guidelines have been updated taking into account the role of CCT, which is able to provide a reliable and fast diagnosis with an additional resources optimization. Multiple registries and trials have been developed and will be summarized in this review. Recent guidelines highlighted the role of CCT in diagnosing suspected CAD.

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Section: Breakthrough Of Cct In the Clinical Scenariomentioning

confidence: 95%

Updated diagnostic & prognostic paradigm for CAD: a narrative review

Toia¹,

Grutta²,

Smeraldi³

et al. 2020

Cardiovasc Diagn Ther

View full text Add to dashboard Cite

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“…Moreover, stress CMR shows excellent prognostic characteristics and is effective in risk strati cation of patients with known or suspected CAD [5][6][7][8] . The American College of Cardiology Foundation and the American Heart Association have recommended stress perfusion CMR for evaluation of symptomatic patients that show intermediate or high pre-test probability for CAD [9,10] .…”

Section: Introductionmentioning

confidence: 99%

Adenosine Triphosphate (ATP)- A Safe and Effective Vasodilator for Stress Perfusion Cardiac Magnetic Resonance

Kong

Cao

et al. 2021

Preprint

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Purpose The aim of this study was to evaluate the efficiency and safety of adenosine triphosphate (ATP) as a stress agent in a cohort of patients undergoing stress perfusion cardiac magnetic resonance imaging (CMR). Methods This retrospective study was conducted between December 2019 and October 2021 at the Beijing Friendship Hospital, Beijing, China. The study included 107 subjects (age range: 53±11 years; male: female, 62%:38%) with suspected non-obstructive coronary artery disease (NOCAD) that underwent stress CMR. These patients showed typical symptoms such as chest pain (stable and unstable angina pectoris) and <50% epicardial coronary artery stenosis based on coronary angiography. Adverse effects and splenic switch‑off (SSO) phenomenon was evaluated in the patients undergoing stress CMR. Moreover, qualitative and semi-quantitative analysis of inducible ischemia was performed by using stress CMR data. Results The qualitative and semi-quantitative analysis of stress CMR data showed 82 patients with reversible myocardial ischemia. The hemodynamic response was quick and observed within 2 minutes after ATP infusion. Scanning was stopped in three patients because of atrioventricular block. CMR images of seven out of 104 patients were excluded from the final analysis because of inferior quality. During ATP infusion, 31/107 patients (29%) experienced mild adverse effects such as chest pain, flushing, dyspnea, headache, and atrioventricular block. Myocardial infarction and bronchospasms were not observed during ATP infusion. SSO, a marker of adequate stress, was observed in 91% (94/103) of the patients that underwent stress CMR. Conclusion ATP is highly effective and safe to use in stress CMR as a coronary vasodilator.The hemodynamic response is observed within 2 minutes after ATP infusion.The adverse effects during ATP infusion were mild. SSO was observed in 91% of the patients undergoing stress CMR.

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