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Qualitative assessments of myocardial ischemia by cardiac MRI and coronary stenosis by invasive coronary angiography in relation to quantitative perfusion by positron emission tomography in patients with known or suspected stable coronary artery disease

Akil, Shahnaz LU ; Hedeer, Fredrik LU ; Carlsson, Marcus LU ; Arheden, Håkan LU ; Oddstig, Jenny LU ; Hindorf, Cecilia LU ; Jögi, Jonas LU ; Erlinge, David LU and Engblom, Henrik LU (2018) In Journal of Nuclear Cardiology
Abstract

Background: To relate findings of qualitative evaluation of first-pass perfusion-CMR and anatomical evaluation on coronary angiography (CA) to the reference standard of quantitative perfusion, cardiac PET, in patients with suspected or known stable coronary artery disease (CAD). Methods and Results: Forty-one patients referred for CA due to suspected stable CAD, prospectively performed adenosine stress/rest first-pass perfusion-CMR as well as 13N-NH3 PET on the same day, 4 ± 3 weeks before CA. Angiographers were blinded to PET and CMR results. Regional myocardial flow reserve (MFR) < 2.0 on PET was considered pathological. Vessel territories with stress-induced ischemia by CMR or vessels with stenosis needing... (More)

Background: To relate findings of qualitative evaluation of first-pass perfusion-CMR and anatomical evaluation on coronary angiography (CA) to the reference standard of quantitative perfusion, cardiac PET, in patients with suspected or known stable coronary artery disease (CAD). Methods and Results: Forty-one patients referred for CA due to suspected stable CAD, prospectively performed adenosine stress/rest first-pass perfusion-CMR as well as 13N-NH3 PET on the same day, 4 ± 3 weeks before CA. Angiographers were blinded to PET and CMR results. Regional myocardial flow reserve (MFR) < 2.0 on PET was considered pathological. Vessel territories with stress-induced ischemia by CMR or vessels with stenosis needing revascularization had a significantly lower MFR compared to those with no regional stress-induced ischemia or vessels not needing revascularization (P < 0.001). In 4 of 123 vessel territories with stress-induced ischemia by CMR, PET showed a normal MFR. In addition, 12 of 123 vessels that underwent intervention showed normal MFR assessed by PET. Conclusion: The limited performance of qualitative assessment of presence of stable CAD with CMR and CA, when related to quantitative 13N-NH3 cardiac PET, shows the need for fully quantitative assessment of myocardial perfusion and the use of invasive flow reserve measurements for CA, to confirm the need of elective revascularization.

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publication status
epub
subject
keywords
Cardiac magnetic resonance imaging, cardiac positron emission tomography, coronary angiography, coronary artery disease, myocardial flow reserve
in
Journal of Nuclear Cardiology
publisher
Springer
external identifiers
  • scopus:85058210526
ISSN
1071-3581
DOI
10.1007/s12350-018-01555-1
language
English
LU publication?
yes
id
db183f91-38be-4748-a1aa-2cf79e0145ed
date added to LUP
2019-01-08 13:39:57
date last changed
2019-01-09 03:00:04
@article{db183f91-38be-4748-a1aa-2cf79e0145ed,
  abstract     = {<p>Background: To relate findings of qualitative evaluation of first-pass perfusion-CMR and anatomical evaluation on coronary angiography (CA) to the reference standard of quantitative perfusion, cardiac PET, in patients with suspected or known stable coronary artery disease (CAD). Methods and Results: Forty-one patients referred for CA due to suspected stable CAD, prospectively performed adenosine stress/rest first-pass perfusion-CMR as well as <sup>13</sup>N-NH<sub>3</sub> PET on the same day, 4 ± 3 weeks before CA. Angiographers were blinded to PET and CMR results. Regional myocardial flow reserve (MFR) &lt; 2.0 on PET was considered pathological. Vessel territories with stress-induced ischemia by CMR or vessels with stenosis needing revascularization had a significantly lower MFR compared to those with no regional stress-induced ischemia or vessels not needing revascularization (P &lt; 0.001). In 4 of 123 vessel territories with stress-induced ischemia by CMR, PET showed a normal MFR. In addition, 12 of 123 vessels that underwent intervention showed normal MFR assessed by PET. Conclusion: The limited performance of qualitative assessment of presence of stable CAD with CMR and CA, when related to quantitative <sup>13</sup>N-NH<sub>3</sub> cardiac PET, shows the need for fully quantitative assessment of myocardial perfusion and the use of invasive flow reserve measurements for CA, to confirm the need of elective revascularization.</p>},
  author       = {Akil, Shahnaz and Hedeer, Fredrik and Carlsson, Marcus and Arheden, Håkan and Oddstig, Jenny and Hindorf, Cecilia and Jögi, Jonas and Erlinge, David and Engblom, Henrik},
  issn         = {1071-3581},
  keyword      = {Cardiac magnetic resonance imaging,cardiac positron emission tomography,coronary angiography,coronary artery disease,myocardial flow reserve},
  language     = {eng},
  month        = {12},
  publisher    = {Springer},
  series       = {Journal of Nuclear Cardiology},
  title        = {Qualitative assessments of myocardial ischemia by cardiac MRI and coronary stenosis by invasive coronary angiography in relation to quantitative perfusion by positron emission tomography in patients with known or suspected stable coronary artery disease},
  url          = {http://dx.doi.org/10.1007/s12350-018-01555-1},
  year         = {2018},
}