Magnetic resonance imaging versus Doppler guide wire in the assessment of coronary flow reserve in patients with coronary artery disease.
BACKGROUND
Coronary flow velocity reserve (CFVR), defined as the ratio of maximal hyperaemic to baseline flow velocity, has been validated as a marker of physiological significance of a coronary lesion. Clinically, this parameter is measured invasively during X-ray angiography using the Doppler guide wire. With magnetic resonance (MR) imaging it is possible to quantify CFVR non-invasively.


METHODS
The purpose of the study was to compare CFVR, acquired with MR imaging and the Doppler guide wire in patients with coronary artery disease.


METHODS
Twenty-two patients suffering from one- or two-vessel coronary artery disease as derived from diagnostic X-ray coronary angiography were included. Coronary flow velocity reserve was measured at baseline and during maximal hyperaemia, obtained by intravenous administration of adenosine using MR phase contrast velocity quantification. Within 2 weeks CFVR was measured invasively with a Doppler guide wire.


RESULTS
In 26 coronary arteries CFVR was acquired with both techniques. Mean CFVR in the stenosed and healthy reference arteries was 1.5 +/- 0.7 and 2.7 +/- 1.0 (P < 0.01) respectively for MR measurements and 1.9 +/- 0.7 and 3.1 +/- 0.6 (P < 0.01) respectively for Doppler measurements. Bland-Altman analysis revealed a non-significant mean difference between the two techniques of 0.4 +/- 1.2.


CONCLUSIONS
In a selected group of stable patients with coronary artery disease MR flow velocity quantification provides non-invasive data equivalent to the invasive Doppler guide wire data. Variability in both the MR and Doppler ultrasound measurement resulted in a significant scatter of data without systematic difference.
Bedaux
Willemijn L F
WL
Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. wlf.bedaux@VUmc.nl
Hofman
Mark B M
MB
de Cock
Carel C
CC
Stoel
Martin G
MG
Visser
Cees A
CA
van Rossum
Albert C
AC
D001783:Blood Flow Velocity; D016000:Cluster Analysis; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D012984:Software; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional