PMID- 20840783
OWN - NLM
STAT- MEDLINE
DCOM- 20101228
LR  - 20240117
IS  - 1532-429X (Electronic)
IS  - 1097-6647 (Print)
IS  - 1097-6647 (Linking)
VI  - 12
IP  - 1
DP  - 2010 Sep 14
TI  - Staged cardiovascular magnetic resonance for differential diagnosis of troponin T 
      positive patients with low likelihood for acute coronary syndrome.
PG  - 51
LID - 10.1186/1532-429X-12-51 [doi]
AB  - BACKGROUND: Cardiac troponin-T (cTnT) is a cardio-specific indicator of 
      myocardial necrosis due to ischemic or non-ischemic events. Considering the 
      multiple causes of myocardial injury and treatment consequences there is great 
      clinical need to clarify the underlying reason for cTnT release. We sought to 
      implement acute CMR as a non-invasive imaging method for differential diagnosis 
      of elevated cTnT in chest-pain unit (CPU) patients with non-conclusive symptoms 
      and ECG-changes and a low to intermediate probability for coronary artery disease 
      (CAD). RESULTS: CPU patients (n = 29) who had positive cTnT were scanned at 1.5T 
      with a new step-by-step CMR algorithm including cine-, perfusion-, T2-, 
      angiography-and late gadolinium enhancement (LGE) imaging. For comparison 
      patients also underwent echocardiography and coronary angiography if necessary. 
      CMR was conducted successfully in all patients and detected 93% of cTnT releases 
      of unknown cause, without adverse hemodynamic or arrhythmic events. Acute 
      myocardial infarction was detected in 11, pulmonary embolism in 6, myocarditis in 
      5, renal disease and cardiomyopathy in 2, storage disorder in 1 patient. In 2 
      patients CMR was unable to reveal the cause of cTnT elevations. Mean CMR 
      scan-time was 35 +/- 8 min. In 4 patients, CMR led to immediate coronary 
      angiography with correct prediction of the infarct related artery. CONCLUSIONS: 
      We implemented a novel CMR algorithm to show the clinical value and practical 
      feasibility of acute CMR in a non-conclusive patient cohort with unclear cTnT 
      elevation. Since this pilot study has shown the feasibility of CMR in CPU 
      patients, further prospective studies are warranted to compare CMR with other 
      imaging modalities.
FAU - Steen, Henning
AU  - Steen H
AD  - Abteilung Innere Medizin III, Medizinische Klinik, Universitatsklinikum 
      Heidelberg, Heidelberg, Germany. henning.steen@med.uni-heidelberg.de
FAU - Madadi-Schroeder, Media
AU  - Madadi-Schroeder M
FAU - Lehrke, Stephanie
AU  - Lehrke S
FAU - Lossnitzer, Dirk
AU  - Lossnitzer D
FAU - Giannitsis, Evangelos
AU  - Giannitsis E
FAU - Katus, Hugo A
AU  - Katus HA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20100914
PL  - England
TA  - J Cardiovasc Magn Reson
JT  - Journal of cardiovascular magnetic resonance : official journal of the Society 
      for Cardiovascular Magnetic Resonance
JID - 9815616
RN  - 0 (Biomarkers)
RN  - 0 (Contrast Media)
RN  - 0 (Troponin T)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*diagnosis/pathology
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Biomarkers/blood
MH  - Contrast Media
MH  - Coronary Angiography
MH  - Diagnosis, Differential
MH  - Echocardiography
MH  - Electrocardiography
MH  - Feasibility Studies
MH  - Female
MH  - Gadolinium DTPA
MH  - Germany
MH  - Humans
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Troponin T/*blood
MH  - Up-Regulation
PMC - PMC2950012
EDAT- 2010/09/16 06:00
MHDA- 2010/12/29 06:00
PMCR- 2010/09/14
CRDT- 2010/09/16 06:00
PHST- 2010/04/22 00:00 [received]
PHST- 2010/09/14 00:00 [accepted]
PHST- 2010/09/16 06:00 [entrez]
PHST- 2010/09/16 06:00 [pubmed]
PHST- 2010/12/29 06:00 [medline]
PHST- 2010/09/14 00:00 [pmc-release]
AID - S1097-6647(23)01331-5 [pii]
AID - 1532-429X-12-51 [pii]
AID - 10.1186/1532-429X-12-51 [doi]
PST - epublish
SO  - J Cardiovasc Magn Reson. 2010 Sep 14;12(1):51. doi: 10.1186/1532-429X-12-51.