Prognostic Value of Stress Cardiac Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease

Lipinski, Michael J.; McVey, Courtney; Berger, Jeffrey S.; Kramer, Christopher M.; Salerno, Michael

doi:10.1016/j.jacc.2013.03.080

Cited by 225 publications

(92 citation statements)

References 61 publications

(35 reference statements)

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“…The prognostic information of stress CMR was compiled in a meta-analysis from our center by Lipinski et al . [38]. Data was analyzed from 19 studies inclusive of 11,636 patients with known or suspected CAD.…”

Section: Cmr Myocardial Perfusion and Prognosismentioning

confidence: 99%

Cardiac Mri Assessment of Myocardial Perfusion

Hamirani

Kramer

2014

Future Cardiol.

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Coronary artery disease is the most common cause of mortality and morbidity around the globe. Assessment of myocardial perfusion to diagnose ischemia is commonly performed in symptomatic patients prior to referral for cardiac catheterization. Among other noninvasive imaging modalities, cardiac MRI (CMR) is emerging as a highly sensitive and specific test for myocardial ischemia and infarction. Resting perfusion on CMR is used to evaluate for microvascular obstruction, which is shown to predict adverse left ventricular remodeling and cardiac events after acute myocardial infarction. This article summarizes the current understanding of CMR perfusion.

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Section: Cmr Myocardial Perfusion and Prognosismentioning

confidence: 99%

Cardiac Mri Assessment of Myocardial Perfusion

Hamirani

Kramer

2014

Future Cardiol.

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“…4, 5 Recent head-to-head comparisons between stress CMR and SPECT have demonstrated equivalent or superior accuracy of CMR. 6, 7 Despite these advantages, CMR perfusion imaging is still limited by artifacts which may be mistaken for perfusion abnormalities and has limited spatial and temporal resolution.…”

mentioning

confidence: 99%

Adenosine Stress Cardiovascular Magnetic Resonance With Variable-Density Spiral Pulse Sequences Accurately Detects Coronary Artery Disease

Salerno

Taylor

Yang

et al. 2014

Circ: Cardiovascular Imaging

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Background Adenosine stress CMR perfusion imaging can be limited by motion-induced dark-rim artifacts (DRA), which may be mistaken for true perfusion abnormalities. A high-resolution variable-density spiral (VDS) pulse sequence with a novel density compensation strategy has been shown to reduce DRA in first-pass perfusion imaging. We aimed to assess the clinical performance of adenosine stress CMR using this new perfusion sequence to detect obstructive coronary artery disease (CAD). Methods and Results CMR perfusion imaging was performed during adenosine stress (140μg/kg-min) and at rest on a Siemens 1.5T Avanto scanner in 41 subjects with chest pain scheduled for coronary angiography (CA). Perfusion images were acquired during injection of 0.1mmol/kg Gd-DTPA at 3 short-axis locations using a saturation recovery (SR) interleaved VDS pulse sequence. Significant stenosis was defined as >50% by quantitative CA (QCA). Two blinded reviewers evaluated the perfusion images for the presence of adenosine-induced perfusion abnormalities and assessed image quality using a 5 point scale (1 – poor to 5- excellent). The prevalence of obstructive CAD by QCA was 68%. The average sensitivity, specificity, and accuracy were 89%, 85%, and 88% respectively with a positive predictive value and negative predictive value of 93% and 79% respectively. The average image quality score was 4.4±0.7 with only one study with more than mild DRA. There was good inter-reader reliability with a kappa statistic of 0.67. Conclusions Spiral adenosine stress CMR results in high diagnostic accuracy for the detection of obstructive CAD with excellent image quality and minimal DRA.

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“…This could be demonstrated by the data contained in this study (statistical significant increase in c 2 -, NRI-and IDI-values). A large meta-analysis has recently been published [31]. The authors point out that presence of LGE itself is associated with a worse outcome in patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

Cardiac magnetic resonance imaging derived quantification of myocardial ischemia and scar improves risk stratification and patient management in stable coronary artery disease

et al. 2017

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(10.7 ± 12.25% vs. 3.73 ± 8.29%, p < 0.0001) and LGE (21.09 ± 15.11% vs. 17.73 ± 10.72%, p < 0.0001). A risk prediction model containing the extent of ischemia and LGE proved to be superior in comparison to all other models (c² increase: from 39.678 to 56.676, integrated discrimination index: 0.3851, p = 0.0033, net reclassification index: 0.11516, p = 0.0071). The beneficial effect of revascularization tended to be higher in patients with greater extents of ischemia, though statistical significance was not reached. Conclusions: Quantification of myocardial ischemia and LGE was shown to significantly improve existing risk prediction models and might thus lead to an improvement in patient management. (Cardiol J 2017; 24, 3: 293-304)

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Prognostic Value of Stress Cardiac Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease

Cited by 225 publications

References 61 publications

Cardiac Mri Assessment of Myocardial Perfusion

Cardiac Mri Assessment of Myocardial Perfusion

Adenosine Stress Cardiovascular Magnetic Resonance With Variable-Density Spiral Pulse Sequences Accurately Detects Coronary Artery Disease

Cardiac magnetic resonance imaging derived quantification of myocardial ischemia and scar improves risk stratification and patient management in stable coronary artery disease

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