Combined Assessment of Myocardial Perfusion and Late Gadolinium Enhancement in Patients After Percutaneous Coronary Intervention or Bypass Grafts

Bernhardt, Peter; Spiess, Jochen; Levenson, Benny; Pilz, Günter; Höfling, B.; Hombach, Vinzenz; Strohm, Oliver

doi:10.1016/j.jcmg.2009.05.011

Cited by 56 publications

(43 citation statements)

References 33 publications

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“…Patients with a known history of prior CAD, MI, or prior PCI were eligible for the study; however, patients with prior coronary artery bypass surgery (CABG) were excluded as adenosine stress CMR has been shown to have different test characteristics in this population. 18 Exclusion criteria included known EF<45%, evaluation for workup of cardiomyopathy, significant valvular pathology, pulmonary hypertension, or transplant vasculopathy, GFR < 45 mL/min/1.73m2, contraindications to MRI including implantable cardiac devices, contraindications to adenosine infusion (asthma or severe COPD), or a history of prior gadolinium contrast reaction. All patients had their renal function assessed within 30 days prior to the CMR study.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

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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“…CMR imaging was conducted according to well established standards in conformity with current guidelines [22][23][24].…”

Section: Cmr Examinationmentioning

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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“…49 Moreover, first-pass perfusion with adenosine stress CMR imaging combined with LGE was shown to be highly accurate in detecting inducible ischemia in patients post-PCI and to a lesser extent following a coronary bypass graft. 50 …”

Section: Role In Detecting Inducible Ischemia In Patients With Known mentioning

confidence: 99%

Stress Cardiac MR Imaging

Sayari¹,

Kopp²,

Bremerich³

2015

Radiologic Clinics of North America

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Combined Assessment of Myocardial Perfusion and Late Gadolinium Enhancement in Patients After Percutaneous Coronary Intervention or Bypass Grafts

Cited by 56 publications

References 33 publications

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

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

Stress Cardiac MR Imaging

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