title: Prognostic value of dipyridamole stress cardiac magnetic resonance in patients with known or suspected coronary artery disease: a mid-term follow-up study.
abstract: OBJECTIVE
  Dipyridamole stress cardiac magnetic resonance (CMR) evaluates the key phases (perfusion and wall motion) of the ischemic cascade. We sought to determine the prognostic value of dipyridamole stress-CMR in consecutive patients symptomatic for chest pain.
  
  
  METHODS
  Seven hundred and ninety-three consecutive patients symptomatic for chest pain underwent dipyridamole stress-CMR and were followed up for 810 ± 665 days. Patients were classified in group 1 (no- reversible ischemia), group 2 (stress perfusion defect alone), and group 3 [stress perfusion defect plus abnormal wall motion (AWM)]. End points were "all cardiac events" (myocardial infarction, cardiac death and revascularization) and "hard cardiac events" (all cardiac events excluding revascularization).
  
  
  RESULTS
  One hundred and ninety-five (24 %) all cardiac events and 53 (7 %) hard cardiac events were observed. All and hard cardiac event rates in groups 1, 2, and 3 were 11 %, 49 %, 69 % and 4 %, 8 %, 21 %, respectively, with a higher rate in group 2 vs. group 1 (p<0.01) and group 3 vs. groups 1 and 2 (p<0.01). Multivariate analysis showed the presence of late gadolinium enhancement and stress perfusion defect plus AWM as independent predictors of all and hard cardiac events.
  
  
  CONCLUSIONS
  Dipyridamole stress-CMR improves prognostic stratification of patients through differentiation between the different components of the ischemic cascade.
  
  
  CONCLUSIONS
  • Dipyridamole stress cardiac magnetic resonance helps to assess coronary artery disease. • Novel technique to study the key phases of myocardial ischemia. • Combined assessment of perfusion and motion defects. • Dipyridamole stress imaging has additional value for predicting cardiac events.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy. gianluca.pontone@ccfm.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.|Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Bertella
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Loguercio
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Guglielmo
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baggiano
authors.affiliation: Fondazione CNR/Regione Toscana "G. Monasterio", Pisa, Italy.
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.affiliation: Institute of Cardiology "G. D'Annunzio", Chieti, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Salerni
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gripari
authors.affiliation: Institute of Cardiology "G. D'Annunzio", Chieti, Italy.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rossi
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Segurini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Conte
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Virginia
authors.initials: V
authors.lastname: Beltrama
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Giovannardi
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Veglia
authors.affiliation: Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital "Policlinico Consorziale" of Bari, Bari, Italy.
authors.forename: Andrea Igoren
authors.initials: AI
authors.lastname: Guaricci
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.|Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.|Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
authors.affiliation: Fondazione CNR/Regione Toscana "G. Monasterio", Pisa, Italy.
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Masci
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002637:Chest Pain / Q000209:etiology; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D055414:Myocardial Perfusion Imaging; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D011379:Prognosis; D014665:Vasodilator Agents
chemical_list: D003287:Contrast Media; D014665:Vasodilator Agents; D004176:Dipyridamole; D005682:Gadolinium
keywords: Coronary artery disease; Magnetic resonance; Myocardial ischemia; Myocardial perfusion imaging; Prognosis