title: Adenosine stress cardiac magnetic resonance imaging for the assessment of ischemic heart disease.
abstract: OBJECTIVE
  This prospective study was designed to determine the diagnostic value of adenosine stress cardiac magnetic resonance imaging (CMRI) in patients referred to elective coronary angiography.
  
  
  RESULTS
  Myocardial perfusion measurements at rest and adenosine stress were performed in 141 patients (105 men, 36 women, mean age 63.4 years) at 1.5 T with a Turbo Flash sequence. Stress-induced perfusion deficits were correlated to angiographic stenoses > or =75%. The overall sensitivity for CMRI depicting coronary artery disease (CAD) with relevant stenoses was 90.4%, the specificity was 77.4%, the positive predictive value was 85.9%, the negative predictive value was 84.2% and the accuracy 85.2%. Subgroup analysis was performed for 3-vessel disease (n = 44, sensitivity 92.3%, specificity 75.0%), 2-vessel disease (n = 43, sensitivity 92.6%, specificity 92.9%), 1-vessel disease (n = 27, sensitivity 93.1%, specificity 71.4%) and patients without CAD (n = 27, specificity 70.4%) as well as for patients with prior myocardial infarction (n = 44, sensitivity 92.9%, specificity 86.7%), prior coronary artery bypass surgery (n = 21, sensitivity 88.2%, specificity 66.7%), prior coronary interventions (n = 88, sensitivity 91.9%, specificity 75.0%), or diabetics (n = 27, sensitivity 90.5%, specificity 83.3%).
  
  
  CONCLUSIONS
  Our study shows that stress perfusion CMRI can accurately predict relevant CAD and contributes to the identification of hemodynamic relevant stenoses in patients scheduled for coronary angiography.
authors.affiliation: Department of Cardiology, Eberhard Karls University, Tübingen, Otfried-Müller Str. 10, 72076, Tübingen, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Doesch
authors.forename: Achim
authors.initials: A
authors.lastname: Seeger
authors.forename: Tobias
authors.initials: T
authors.lastname: Hoevelborn
authors.forename: Bernhard
authors.initials: B
authors.lastname: Klumpp
authors.forename: Michael
authors.initials: M
authors.lastname: Fenchel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kramer
authors.forename: Birgitt
authors.initials: B
authors.lastname: Schönfisch
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Meinrad
authors.initials: M
authors.lastname: Gawaz
authors.forename: Stephan
authors.initials: S
authors.lastname: Miller
authors.forename: Andreas E
authors.initials: AE
authors.lastname: May
mesh_terms: D000241:Adenosine; D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis; D023921:Coronary Stenosis / Q000175:diagnosis; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine
references.citation: Clin Res Cardiol. 2006 Oct;95(10):531-8
references.pmid: 16897145
references.citation: Circulation. 2000 Mar 28;101(12):1379-83
references.pmid: 10736280
references.citation: Circulation. 2001 Nov 13;104(20):2412-6
references.pmid: 11705817
references.citation: AJR Am J Roentgenol. 2005 Sep;185(3):627-35
references.pmid: 16120910
references.citation: Radiology. 2005 May;235(2):423-30
references.pmid: 15858084
references.citation: J Magn Reson Imaging. 2004 Jun;19(6):758-70
references.pmid: 15170782
references.citation: Int J Card Imaging. 1997 Jun;13(3):205-18
references.pmid: 9220283
references.citation: J Cardiovasc Magn Reson. 2004;6(4):803-9
references.pmid: 15646883
references.citation: Eur Heart J. 1996 Apr;17(4):635-42
references.pmid: 8733099
references.citation: Clin Res Cardiol. 2008 Apr;97(4):280-3
references.pmid: 18193372
references.citation: Radiology. 1997 Aug;204(2):373-84
references.pmid: 9240523
references.citation: Clin Res Cardiol. 2007 Jun;96(6):375-82
references.pmid: 17453137
references.citation: J Nucl Cardiol. 2006 Nov;13(6):841-54
references.pmid: 17174815
references.citation: Lancet. 2003 Feb 1;361(9355):374-9
references.pmid: 12573373
references.citation: J Am Coll Cardiol. 1999 Apr;33(5):1386-94
references.pmid: 10193743
references.citation: Int J Cardiovasc Imaging. 2002 Feb;18(1):539-42
references.pmid: 12135124
references.citation: Eur Heart J. 2006 Jun;27(12):1465-71
references.pmid: 16720685
references.citation: Circulation. 2001 May 8;103(18):2230-5
references.pmid: 11342469
references.citation: J Am Coll Cardiol. 2000 Nov 1;36(5):1557-64
references.pmid: 11079658
references.citation: Magn Reson Med. 1996 Feb;35(2):221-8
references.pmid: 8622587
references.citation: Clin Res Cardiol. 2008 Oct;97(10):760-7
references.pmid: 18516488
references.citation: J Am Coll Cardiol. 2006 Apr 4;47(7):1427-32
references.pmid: 16580532
references.citation: Circulation. 2003 Jul 29;108(4):432-7
references.pmid: 12860910
references.citation: J Am Coll Cardiol. 2006 Apr 18;47(8):1630-8
references.pmid: 16631001
references.citation: Eur Heart J. 2008 Feb;29(4):480-9
references.pmid: 18208849
references.citation: Circulation. 1997 Nov 4;96(9):2859-67
references.pmid: 9386150