title: Cardiac magnetic resonance performs better in the detection of functionally significant coronary artery stenosis compared to single-photon emission computed tomography and dobutamine stress echocardiography.
abstract: BACKGROUND
  Fractional flow reserve (FFR) measured on catheterization is now widely used for the diagnosis of functional myocardial ischemia in patients with coronary artery disease (CAD). FFR, however, is invasive and carries potential procedural complications. Therefore, the aim of this study was to compare the diagnostic capability in functionally significant stenosis identified on FFR, between cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI), single-photon emission computed tomography MPI (SPECT-MPI), and dobutamine stress echocardiography (DSE) in patients with CAD.
  
  
  RESULTS
  A total of 25 patients who had at least 1 angiographic stenosis ≥50% on coronary angiography was studied. CMR-MPI, SPECT-MPI and DSE were done before FFR measurement. FFR was measured in all 3 major epicardial coronary arteries. Out of 71 vascular territories excluding 4 territories due to inadequate imaging, 29 (41%) had FFR <0.80. The sensitivity of CMR-MPI was significantly higher than that of SPECT-MPI and DSE (P=0.02 and P=0.001, respectively). The area under the receiver operating characteristic curve (AUC) for CMR-MPI (AUC, 0.92) was significantly greater than for SPECT-MPI (AUC, 0.73; P=0.006) and DSE (AUC, 0.69; P<0.001).
  
  
  CONCLUSIONS
  CMR-MPI performed well in the detection of functionally significant stenosis defined according to FFR, and had the highest diagnostic sensitivity among the 3 modalities tested in patients with CAD.
authors.affiliation: Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Kamiya
authors.forename: Mamoru
authors.initials: M
authors.lastname: Sakakibara
authors.forename: Naoya
authors.initials: N
authors.lastname: Asakawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshitani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Iwano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Komatsu
authors.forename: Masanao
authors.initials: M
authors.lastname: Naya
authors.forename: Satoru
authors.initials: S
authors.lastname: Chiba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Osamu
authors.initials: O
authors.lastname: Manabe
authors.forename: Yasuka
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.forename: Koji
authors.initials: K
authors.lastname: Oba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsui
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis*; D025401:Echocardiography, Stress / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*