AI Article Synopsis
- The study explores the effectiveness of high-resolution free-breathing stress perfusion cardiovascular magnetic resonance (SP-CMR) in diagnosing coronary artery disease (CAD) compared to invasive coronary angiography (ICA) with fractional flow reserve (FFR) measurement.
- A total of 703 patients underwent SP-CMR, with a focus on generating myocardial blood flow (MBF) maps to calculate myocardial perfusion reserve (MPR) and assess coronary vessels' health.
- The findings indicate that specific stress MBF and MPR values can accurately identify functionally significant CAD, demonstrating the potential of this automated SP-CMR technique for improved diagnostic accuracy.
Article Abstract
Aims: Current assessment of myocardial ischaemia from stress perfusion cardiovascular magnetic resonance (SP-CMR) largely relies on visual interpretation. This study investigated the use of high-resolution free-breathing SP-CMR with automated quantitative mapping in the diagnosis of coronary artery disease (CAD). Diagnostic performance was evaluated against invasive coronary angiography (ICA) with fractional flow reserve (FFR) measurement.
Methods And Results: Seven hundred and three patients were recruited for SP-CMR using the research sequence at 3 Tesla. Of those receiving ICA within 6 months, 80 patients had either FFR measurement or identification of a chronic total occlusion (CTO) with inducible perfusion defects seen on SP-CMR. Myocardial blood flow (MBF) maps were automatically generated in-line on the scanner following image acquisition at hyperaemic stress and rest, allowing myocardial perfusion reserve (MPR) calculation. Seventy-five coronary vessels assessed by FFR and 28 vessels with CTO were evaluated at both segmental and coronary territory level. Coronary territory stress MBF and MPR were reduced in FFR-positive (≤0.80) regions [median stress MBF: 1.74 (0.90-2.17) mL/min/g; MPR: 1.67 (1.10-1.89)] compared with FFR-negative regions [stress MBF: 2.50 (2.15-2.95) mL/min/g; MPR 2.35 (2.06-2.54) P < 0.001 for both]. Stress MBF ≤ 1.94 mL/min/g and MPR ≤ 1.97 accurately detected FFR-positive CAD on a per-vessel basis (area under the curve: 0.85 and 0.96, respectively; P < 0.001 for both).
Conclusion: A novel scanner-integrated high-resolution free-breathing SP-CMR sequence with automated in-line perfusion mapping is presented which accurately detects functionally significant CAD.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210990 | PMC |
| http://dx.doi.org/10.1093/ehjci/jeae084 | DOI Listing |
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