title: [Early diagnosis of the functional relevance of coronary heart disease].
abstract: In cases of stable or to a large extent symptom-free coronary heart disease (CHD) and atypical symptomatology, the indication for diagnostic cardiac catheterization is first confirmed by noninvasive diagnostics of ischemia. This can be carried out either with ergometric stress tests or imaging procedures in combination with ergometric or pharmacological stress. Myocardial scintigraphy and stress echocardiography are established techniques and to an increasing extent stress magnetic resonance imaging (MRI). In addition to sensitivity in providing evidence for ischemia, technical improvements in computed tomography (CT) and MRI have opened up new possibilities for visualizing coronary vessels and vascular wall morphology. While CT coronary angiography with its high spatial resolution is on the threshold of clinical application for selected patients, MRI has the potential for furnishing information on wall movement analysis, perfusion, coronary flow measurement, and plaque characterization to become the future cardiovascular "all-round examination".
authors.affiliation: Klinik III für Innere Medizin, Universität zu Köln. frank.baer@uni-koeln.de
authors.forename: F M
authors.initials: FM
authors.lastname: Baer
mesh_terms: D003324:Coronary Artery Disease / Q000145:classification* / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D003951:Diagnostic Errors / Q000517:prevention & control*; D003952:Diagnostic Imaging / Q000379:methods*; D005080:Exercise Test; D006801:Humans; D017202:Myocardial Ischemia / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors
references.citation: Circulation. 1999 Feb 16;99(6):763-70
references.pmid: 9989961
references.citation: Circulation. 2003 Jan 7;107(1):149-58
references.pmid: 12515758
references.citation: Lancet. 1998 Nov 7;352(9139):1530
references.pmid: 10681221
references.citation: Dtsch Med Wochenschr. 1995 Dec 22;120(51-52):1761-7
references.pmid: 8549260
references.citation: Circulation. 2003 Feb 11;107(5):664-6
references.pmid: 12578863
references.citation: Lancet. 2002 Jun 8;359(9322):2027-9
references.pmid: 12076573
references.citation: N Engl J Med. 1998 Jun 4;338(23):1650-6
references.pmid: 9614255
references.citation: J Am Coll Cardiol. 1991 Mar 1;17(3):666-9
references.pmid: 1993786
references.citation: J Magn Reson Imaging. 2004 Jun;19(6):710-9
references.pmid: 15170778
references.citation: Ann Intern Med. 1993 Jan 15;118(2):81-90
references.pmid: 8416322
references.citation: Radiology. 1994 Oct;193(1):203-9
references.pmid: 8090892
references.citation: J Am Coll Cardiol. 2001 Feb;37(2):451-7
references.pmid: 11216962
references.citation: Circulation. 2000 Aug 1;102(5):506-10
references.pmid: 10920061
references.citation: N Engl J Med. 2001 Dec 27;345(26):1863-9
references.pmid: 11756576
references.citation: Am Heart J. 2002 Aug;144(2):212-8
references.pmid: 12177636
references.citation: J Magn Reson Imaging. 2004 Sep;20(3):395-402
references.pmid: 15332246
references.citation: Herz. 1996 Apr;21(2):75-7
references.pmid: 8682440
references.citation: Eur Heart J. 2003 Sep;24(17):1601-10
references.pmid: 12964575
references.citation: Ann Intern Med. 1999 May 4;130(9):719-28
references.pmid: 10357690
references.citation: Circulation. 2000 Mar 28;101(12):1379-83
references.pmid: 10736280
references.citation: N Engl J Med. 2004 Sep 23;351(13):1296-305
references.pmid: 15385656
references.citation: Herz. 2003 Mar;28(2):119-25
references.pmid: 12669225
references.citation: Circulation. 2001 Sep 25;104(13):1550-6
references.pmid: 11571251
references.citation: Circulation. 1997 Jul 1;96(1):345-54
references.pmid: 9236456
references.citation: Circulation. 2003 May 27;107(20):2571-6
references.pmid: 12743005
references.citation: Circulation. 2004 Sep 14;110(11):1463-6
references.pmid: 15238457
references.citation: Circulation. 2002 Oct 8;106(15):2026-34
references.pmid: 12370230
references.citation: Circulation. 2004 Jan 6;109 (1):14-7
references.pmid: 14691045