Complementary Prognostic Values of Stress Myocardial Perfusion and Late Gadolinium Enhancement Imaging by Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

Steel, Kevin; Broderick, Ryan; Gandla, Vijay; Larose, Éric; Resnic, Frederick; Jerosch‐Herold, Michael; Brown, Kenneth A.; Kwong, Raymond Y.

doi:10.1161/circulationaha.108.812503

Cited by 141 publications

(81 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, they concluded that CMR-derived results provide rather complementary than overlapping information. This finding is consistent with other recently published studies [30]. The present hypothesis was that a risk prediction model containing myocardial ischemia and LGE only as dichotomous variables could further be improved by quantification of these parameters.…”

Section: Discussionsupporting

confidence: 93%

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

View full text Add to dashboard Cite

(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)

show abstract

Section: Discussionsupporting

confidence: 93%

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

View full text Add to dashboard Cite

show abstract

“…It is important however to recognize that LGE can be caused by other diseases apart from CAD, such as hypertrophic or dilated cardiomyopathy [21,22]. Also, unrecognized myocardial infarction as depicted by LGE can occur as the result of a spontaneous thrombolysis and recannulation of an acute coronary lesion [23]. On the other hand, coronary stenosis in patients with CAD not necessarily leads to scarification of the myocardium, which is underlined by the low sensitivity of LGE imaging in our patient cohort.…”

Section: Cmrmentioning

confidence: 86%

Low-dose CT and cardiac MR for the diagnosis of coronary artery disease: accuracy of single and combined approaches

Scheffel

Stolzmann

Alkadhi

et al. 2010

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Purpose: To prospectively compare the diagnostic performance of low-dose computed tomography coronary angiography (CTCA) and cardiac magnetic resonance imaging (CMR) and combinations thereof for the diagnosis of significant coronary stenoses. Materials and Methods:Forty-three consecutive patients with known or suspected coronary artery disease underwent catheter coronary angiography (CA), dual-source CTCA with prospective electrocardiography-gating, and cardiac CMR (1.5 Tesla).The following tests were analyzed: 1) low-dose CTCA, 2) adenosine stress-rest perfusion-CMR, 3) late gadolinium enhancement (LGE), 4) perfusion-CMR and LGE, 5) low-dose CTCA combined with perfusion-CMR, 5) low-dose CTCA combined with late gadolinium-enhancement, 6) low-dose CTCA combined with perfusion-CMR andLGE. CA served as the standard of reference.Results: CA revealed >50% diameter stenoses in 68/129 (57.7%) coronary arteries in 29/43 (70%) patients. In the patient-based analysis, sensitivity, specificity, NPV and PPV of low-dose CTCA for the detection of significant stenoses were 100%, 92.9%, 100% and 96.7%, respectively. For perfusion-CMR and LGE, sensitivity, specificity, NPV, PPV, and accuracy were 89.7%, 100%, 82.4%, and 100%, respectively. In the artery-based analysis, sensitivity and NPV of low-dose CTCA was significantly (p<0.05) higher than that of perfusion-CMR and LGE. All combinations of low-dose CTCA and perfusion-CMR and/or LGE did not improve the diagnostic performance when compared to low-dose CTCA alone. Conclusion:Taking CA as standard of reference, low-dose CTCA outperforms CMR with regard to sensitivity and NPV, whereas CMR is more specific and has a higher PPV than low-dose CTCA. 4Word count: 245

show abstract

“…86 A new superparamagnetic iron oxide probe conjugated to recombinant human annexin has demonstrated diffuse myocardial signal loss in rats treated with doxorubicin, suggestive of apoptosis by CMR. 87,88 Myocardial fibrosis detected as delayed enhancement (DE) by CMR has proven prognostic value in coronary heart disease, 89 and restrictive myocardial diseases including aortic stenosis, 90 hypertrophic cardiomyopathy, 91,92 and the infiltrative diseases of sarcoidosis 93 and amyloidosis. 94 CMR studies in larger populations of patients receiving potentially cardiotoxic agents are needed to see whether the presence of fibrosis detected by gadolinium enhancement identifies a cohort of patients more vulnerable to the cardiotoxic effects of chemotherapy, who may benefit from more frequent and long-term follow-up, and earlier treatment with ACE inhibitors and beta blockade to reduce the incidence and severity of chemotherapy-induced heart failure.…”

Section: Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Schwartz

Jain

Storozynsky

2013

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

The field of cardio-oncology is challenged to address an ever greater spectrum of cardiotoxicity associated with combination chemotherapy, greater dose intensity, extremes of age, and enhanced patient survival which exposes more protracted risk of developing congestive heart failure (CHF). Recent reports of chemotherapy-induced hypertension as a common adverse effect of angiogenesis inhibitors and immunosuppressants clarify the need for routine blood pressure (BP) monitoring and guideline-based management of hypertension as an integral strategy to preserve LV function. Serial monitoring of radionuclide left ventricular ejection fraction (LVEF) in adults and echocardiography in children continues to provide outcome based, cost-effective prevention of CHF in high risk patients receiving chemotherapy. To optimize treatment and monitoring strategies to eliminate late-onset LV dysfunction and CHF, traditional and novel candidate methods for assessment of chemotherapy-induced LV dysfunction are reviewed. These include serial assessment of LV volume indices by gated SPECT ERNA and gated SPECT MPI, 3D echocardiography and contrast 2D echocardiography; longitudinal strain imaging, diastolic functional parameters, 123 I-MIBG, 111 In-Antimyosin antibody imaging, and 99m Tc-Annexin V apoptosis imaging, biomarkers including troponins and BNP; genetic markers, and both functional and tissue characterization techniques with T1 weighted and T2 weighted images with cardiac magnetic resonance imaging (CMR). In our quest to optimize strategies for long-term cancer survival and prevention of CHF for patients receiving chemotherapy, rigorous modality and guideline-specific clinical outcome trials are required. A new multi-modality monitoring approach is proposed, which integrates evidencebased strengths of CMR, echocardiography, ERNA, biomarkers, and BP management for surveillance and validation of cardiotoxicity and prevention of clinical heart failure in patients receiving a broad spectrum of cancer therapies.

show abstract

Complementary Prognostic Values of Stress Myocardial Perfusion and Late Gadolinium Enhancement Imaging by Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease

Cited by 141 publications

References 16 publications

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

Low-dose CT and cardiac MR for the diagnosis of coronary artery disease: accuracy of single and combined approaches

Traditional and novel methods to assess and prevent chemotherapy-related cardiac dysfunction noninvasively

Contact Info

Product

Resources

About