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Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging

AIMS: This study compared the myocardial ischaemic burden (MIB) in patients with angiographic three-vessel coronary artery disease (3VD) using high-resolution and standard-resolution myocardial perfusion cardiovascular magnetic resonance (perfusion CMR) imaging. METHODS AND RESULTS: One hundred and...

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Autores principales: Motwani, Manish, Maredia, Neil, Fairbairn, Timothy A., Kozerke, Sebastian, Greenwood, John P., Plein, Sven
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024983/
https://www.ncbi.nlm.nih.gov/pubmed/24493156
http://dx.doi.org/10.1093/ehjci/jet286
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author Motwani, Manish
Maredia, Neil
Fairbairn, Timothy A.
Kozerke, Sebastian
Greenwood, John P.
Plein, Sven
author_facet Motwani, Manish
Maredia, Neil
Fairbairn, Timothy A.
Kozerke, Sebastian
Greenwood, John P.
Plein, Sven
author_sort Motwani, Manish
collection PubMed
description AIMS: This study compared the myocardial ischaemic burden (MIB) in patients with angiographic three-vessel coronary artery disease (3VD) using high-resolution and standard-resolution myocardial perfusion cardiovascular magnetic resonance (perfusion CMR) imaging. METHODS AND RESULTS: One hundred and five patients undergoing coronary angiography had two separate stress/rest perfusion CMR studies, one with standard-resolution (2.5 mm in-plane) and another with high-resolution (1.6 mm in-plane). Quantitative coronary angiography was used to define patients with angiographic 3VD. Perfusion CMR images were anonymized, randomly ordered and visually reported by two observers acting in consensus and blinded to all clinical and angiographic data. Perfusion was graded in each segment on a four-point scale and summed to produce a perfusion score and estimate of MIB for each patient. In patients with angiographic 3VD (n = 35), high-resolution acquisition identified more abnormal segments (7.2 ± 3.8 vs. 5.3 ± 4.0; P = 0.004) and territories (2.4 ± 0.9 vs. 1.6 ± 1.1; P = 0.002) and a higher overall perfusion score (20.1 ± 7.7 vs. 11.9 ± 9.4; P < 0.0001) per patient compared with standard-resolution. The number of segments with subendocardial ischaemia was greater with high-resolution acquisition (195 vs. 101; P < 0.0001). Hypoperfusion in all three territories was identified in 57% of 3VD patients by high-resolution compared with only 29% by standard-resolution (P = 0.04). The area-under-the-curve (AUC) for detecting angiographic 3VD using the estimated MIB was significantly greater with high-resolution than standard-resolution acquisition (AUC = 0.90 vs. 0.69; P < 0.0001). CONCLUSION: In patients with angiographic 3VD, the ischaemic burden detected by perfusion CMR is greater with high-resolution acquisition due to better detection of subendocardial ischaemia. High-resolution perfusion CMR may therefore be preferred for risk stratification and management of this high-risk patient group.
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spelling pubmed-40249832014-05-19 Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging Motwani, Manish Maredia, Neil Fairbairn, Timothy A. Kozerke, Sebastian Greenwood, John P. Plein, Sven Eur Heart J Cardiovasc Imaging Original Articles AIMS: This study compared the myocardial ischaemic burden (MIB) in patients with angiographic three-vessel coronary artery disease (3VD) using high-resolution and standard-resolution myocardial perfusion cardiovascular magnetic resonance (perfusion CMR) imaging. METHODS AND RESULTS: One hundred and five patients undergoing coronary angiography had two separate stress/rest perfusion CMR studies, one with standard-resolution (2.5 mm in-plane) and another with high-resolution (1.6 mm in-plane). Quantitative coronary angiography was used to define patients with angiographic 3VD. Perfusion CMR images were anonymized, randomly ordered and visually reported by two observers acting in consensus and blinded to all clinical and angiographic data. Perfusion was graded in each segment on a four-point scale and summed to produce a perfusion score and estimate of MIB for each patient. In patients with angiographic 3VD (n = 35), high-resolution acquisition identified more abnormal segments (7.2 ± 3.8 vs. 5.3 ± 4.0; P = 0.004) and territories (2.4 ± 0.9 vs. 1.6 ± 1.1; P = 0.002) and a higher overall perfusion score (20.1 ± 7.7 vs. 11.9 ± 9.4; P < 0.0001) per patient compared with standard-resolution. The number of segments with subendocardial ischaemia was greater with high-resolution acquisition (195 vs. 101; P < 0.0001). Hypoperfusion in all three territories was identified in 57% of 3VD patients by high-resolution compared with only 29% by standard-resolution (P = 0.04). The area-under-the-curve (AUC) for detecting angiographic 3VD using the estimated MIB was significantly greater with high-resolution than standard-resolution acquisition (AUC = 0.90 vs. 0.69; P < 0.0001). CONCLUSION: In patients with angiographic 3VD, the ischaemic burden detected by perfusion CMR is greater with high-resolution acquisition due to better detection of subendocardial ischaemia. High-resolution perfusion CMR may therefore be preferred for risk stratification and management of this high-risk patient group. Oxford University Press 2014-06 2014-02-03 /pmc/articles/PMC4024983/ /pubmed/24493156 http://dx.doi.org/10.1093/ehjci/jet286 Text en © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Motwani, Manish
Maredia, Neil
Fairbairn, Timothy A.
Kozerke, Sebastian
Greenwood, John P.
Plein, Sven
Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title_full Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title_fullStr Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title_full_unstemmed Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title_short Assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
title_sort assessment of ischaemic burden in angiographic three-vessel coronary artery disease with high-resolution myocardial perfusion cardiovascular magnetic resonance imaging
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024983/
https://www.ncbi.nlm.nih.gov/pubmed/24493156
http://dx.doi.org/10.1093/ehjci/jet286
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