PMID- 23833284
OWN - NLM
STAT- MEDLINE
DCOM- 20131114
LR  - 20151119
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 6
IP  - 5
DP  - 2013 Sep
TI  - Additive value of magnetic resonance coronary angiography in a comprehensive 
      cardiac magnetic resonance stress-rest protocol for detection of functionally 
      significant coronary artery disease: a pilot study.
PG  - 730-8
LID - 10.1161/CIRCIMAGING.113.000280 [doi]
AB  - BACKGROUND: Cardiovascular magnetic resonance (CMR) myocardial perfusion imaging 
      (MPI) is a state-of-the-art noninvasive modality for detection of myocardial 
      ischemia and coronary artery disease. Magnetic resonance coronary angiography 
      (MRCA) allows visualization of the coronary tree, but its incremental value as 
      part of a CMR protocol including MPI and late gadolinium enhancement (LGE) is not 
      well established. We aimed to evaluate the additive diagnostic value of a 
      3-dimensional whole-heart MRCA integration into a 1.5T CMR-MPI/LGE protocol for 
      the detection of functionally significant coronary artery disease. METHODS AND 
      RESULTS: Forty-three symptomatic patients (61 +/- 8.3 years; 65% men) with 
      suspected coronary artery disease and intermediate/high-pretest probability 
      underwent CMR (including CMR-MPI, MRCA, and LGE) and x-ray invasive coronary 
      angiography (XA) with fractional flow reserve evaluation. Diagnostic performances 
      of MRCA, CMR-MPI/LGE, and MRCA+CMR-MPI/LGE integration were determined having 
      XA+fractional flow reserve as standard for coronary artery disease (>/=90% 
      stenosis/occlusion or fractional flow reserve </= 0.80 in vessels>2 mm). MRCA 
      inclusion into the CMR protocol was associated with a mean increase of 7.9 +/- 4.69 
      (0-17.7) minutes in total examination duration (14%). On patient-based analysis, 
      MRCA had 96% sensitivity, 68% specificity, positive predictive value of 79%, and 
      negative predictive value of 93%. CMR-MPI/LGE had 79% sensitivity, 95% 
      specificity, positive predictive value of 95%, and negative predictive value of 
      78%. Integration of MRCA with CMR-MPI/LGE further improved CMR performance to 96% 
      sensitivity, 89% specificity, positive predictive value of 92%, and negative 
      predictive value of 94%, with a global accuracy of 93%. CONCLUSIONS: In this 
      intermediate/high-pretest population, integration of noncontrast-enhanced 
      whole-heart MRCA nonsignificantly improved per-patient diagnostic accuracy of a 
      comprehensive 1.5-T stress-rest CMR-MPI/LGE protocol at a cost of longer scanning 
      times.
FAU - Bettencourt, Nuno
AU  - Bettencourt N
AD  - Departments of Cardiology.
FAU - Ferreira, Nuno
AU  - Ferreira N
FAU - Chiribiri, Amedeo
AU  - Chiribiri A
FAU - Schuster, Andreas
AU  - Schuster A
FAU - Sampaio, Francisco
AU  - Sampaio F
FAU - Santos, Lino
AU  - Santos L
FAU - Melica, Bruno
AU  - Melica B
FAU - Rodrigues, Alberto
AU  - Rodrigues A
FAU - Braga, Pedro
AU  - Braga P
FAU - Teixeira, Madalena
AU  - Teixeira M
FAU - Leite-Moreira, Adelino
AU  - Leite-Moreira A
FAU - Silva-Cardoso, Jose
AU  - Silva-Cardoso J
FAU - Portugal, Pedro
AU  - Portugal P
FAU - Gama, Vasco
AU  - Gama V
FAU - Nagel, Eike
AU  - Nagel E
LA  - eng
PT  - Journal Article
DEP - 20130705
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
SB  - IM
CIN - Circ Cardiovasc Imaging. 2013 Nov;6(6):e75. PMID: 24254485
MH  - Aged
MH  - Contrast Media
MH  - Coronary Angiography/*methods
MH  - *Coronary Circulation
MH  - Coronary Stenosis/*diagnosis/physiopathology
MH  - *Exercise Test
MH  - Female
MH  - Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - *Magnetic Resonance Angiography
MH  - Male
MH  - Middle Aged
MH  - Myocardial Perfusion Imaging/*methods
MH  - Pilot Projects
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Severity of Illness Index
MH  - Time Factors
OTO - NOTNLM
OT  - coronary angiography
OT  - fractional flow reserve, myocardial
OT  - magnetic resonance imaging
OT  - perfusion imaging
EDAT- 2013/07/09 06:00
MHDA- 2013/11/15 06:00
CRDT- 2013/07/09 06:00
PHST- 2013/07/09 06:00 [entrez]
PHST- 2013/07/09 06:00 [pubmed]
PHST- 2013/11/15 06:00 [medline]
AID - CIRCIMAGING.113.000280 [pii]
AID - 10.1161/CIRCIMAGING.113.000280 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2013 Sep;6(5):730-8. doi: 
      10.1161/CIRCIMAGING.113.000280. Epub 2013 Jul 5.