Adenosine stress cardiac magnetic resonance imaging for the assessment of ischemic heart disease.
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.
Doesch
Christina
C
Department of Cardiology, Eberhard Karls University, Tübingen, Otfried-Müller Str. 10, 72076, Tübingen, Germany.
Seeger
Achim
A
Hoevelborn
Tobias
T
Klumpp
Bernhard
B
Fenchel
Michael
M
Kramer
Ulrich
U
Schönfisch
Birgitt
B
Claussen
Claus D
CD
Gawaz
Meinrad
M
Miller
Stephan
S
May
Andreas E
AE
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
D014665:Vasodilator Agents; D000241:Adenosine
Clin Res Cardiol. 2006 Oct;95(10):531-8
16897145
Circulation. 2000 Mar 28;101(12):1379-83
10736280
Circulation. 2001 Nov 13;104(20):2412-6
11705817
AJR Am J Roentgenol. 2005 Sep;185(3):627-35
16120910
Radiology. 2005 May;235(2):423-30
15858084
J Magn Reson Imaging. 2004 Jun;19(6):758-70
15170782
Int J Card Imaging. 1997 Jun;13(3):205-18
9220283
J Cardiovasc Magn Reson. 2004;6(4):803-9
15646883
Eur Heart J. 1996 Apr;17(4):635-42
8733099
Clin Res Cardiol. 2008 Apr;97(4):280-3
18193372
Radiology. 1997 Aug;204(2):373-84
9240523
Clin Res Cardiol. 2007 Jun;96(6):375-82
17453137
J Nucl Cardiol. 2006 Nov;13(6):841-54
17174815
Lancet. 2003 Feb 1;361(9355):374-9
12573373
J Am Coll Cardiol. 1999 Apr;33(5):1386-94
10193743
Int J Cardiovasc Imaging. 2002 Feb;18(1):539-42
12135124
Eur Heart J. 2006 Jun;27(12):1465-71
16720685
Circulation. 2001 May 8;103(18):2230-5
11342469
J Am Coll Cardiol. 2000 Nov 1;36(5):1557-64
11079658
Magn Reson Med. 1996 Feb;35(2):221-8
8622587
Clin Res Cardiol. 2008 Oct;97(10):760-7
18516488
J Am Coll Cardiol. 2006 Apr 4;47(7):1427-32
16580532
Circulation. 2003 Jul 29;108(4):432-7
12860910
J Am Coll Cardiol. 2006 Apr 18;47(8):1630-8
16631001
Eur Heart J. 2008 Feb;29(4):480-9
18208849
Circulation. 1997 Nov 4;96(9):2859-67
9386150