Diagnostic performance of quantitative perfusion cardiac magnetic resonance imaging in patients with prior coronary artery disease.

IF 6.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European Heart Journal - Cardiovascular Imaging Pub Date : 2025-01-31 DOI:10.1093/ehjci/jeae262
Roel Hoek, Sonia Borodzicz-Jazdzyk, Pepijn A van Diemen, Yvemarie B O Somsen, Ruben W de Winter, Ruurt A Jukema, Jos W R Twisk, Pieter G Raijmakers, Juhani Knuuti, Teemu Maaniitty, S Richard Underwood, Eike Nagel, Lourens F H J Robbers, Ahmet Demirkiran, Martin B von Bartheld, Roel S Driessen, Ibrahim Danad, Marco J W Götte, Paul Knaapen
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Abstract

Aims: The diagnostic performance of quantitative perfusion cardiac magnetic resonance (QP-CMR) imaging has scarcely been evaluated in patients with a history of coronary artery disease (CAD) and new onset chest pain. The present study compared the diagnostic performance of automated QP-CMR for the detection of fractional flow reserve (FFR) defined hemodynamically significant CAD with visual assessment of first-pass stress perfusion CMR (v-CMR) and quantitative [15O]H2O positron emission tomography (PET) imaging in a true head-to-head fashion in patients with prior CAD.

Methods and results: This PACIFIC-2 substudy included 145 symptomatic chronic coronary symptom patients with prior myocardial infarction and/or percutaneous coronary intervention. All patients underwent dual-sequence, single-bolus perfusion CMR, and [15O]H2O PET perfusion imaging followed by invasive coronary angiography with three-vessel FFR. Hemodynamically significant CAD was defined as an FFR ≤ 0.80. QP-CMR, v-CMR, and PET exhibited a sensitivity of 66, 67, and 80%, respectively, whereas specificity was 60, 62, and 63%. Sensitivity of QP-CMR was lower than that of PET (P = 0.015), whereas the specificity of QP-CMR and PET was comparable. Diagnostic accuracy and area under the curve of QP-CMR (64% and 0.66) was comparable to both v-CMR [66% (P = not significant [NS]) and 0.67 (P = NS)] and PET [74% (P = NS) and 0.78 (P = NS)].

Conclusion: In patients with prior myocardial infarction and/or percutaneous coronary intervention, the diagnostic performance of QP-CMR was comparable to visual assessment of first-pass stress perfusion CMR and quantitative [15O]H2O PET for the detection of hemodynamically significant CAD as defined by FFR.

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定量灌注心脏磁共振成像对既往冠状动脉疾病患者的诊断性能。
目的:定量灌注心脏磁共振(QP-CMR)成像对有冠状动脉疾病(CAD)病史和新发胸痛患者的诊断性能很少进行评估。本研究比较了自动 QP-CMR 在检测分数血流储备(FFR)定义的血流动力学显著性 CAD 方面的诊断性能,以及在既往有 CAD 的患者中以真正的头对头方式对一过应力灌注 CMR(v-CMR)和定量[15O]H2O 正电子发射断层扫描(PET)成像进行视觉评估的诊断性能:这项PACIFIC-2子研究纳入了145名既往患有心肌梗死(MI)和/或经皮冠状动脉介入治疗(PCI)的无症状慢性冠状动脉症状患者。所有患者均接受了双序列、单栓灌注CMR和[15O]H2O PET灌注成像,随后进行了有创冠状动脉造影和三血管FFR检查。FFR≤0.80为有血流动力学意义的CAD。QP-CMR、v-CMR 和 PET 的敏感性分别为 66%、67% 和 80%,特异性分别为 60%、62% 和 63%。QP-CMR 的灵敏度低于 PET(P=0.015),而 QP-CMR 和 PET 的特异性相当。QP-CMR的诊断准确性和曲线下面积(AUC)(64%和0.66)与v-CMR(66% [P=NS]和0.67 (P=NS])和PET(74% [P=NS]和0.78 [P=NS])相当:结论:在既往有心肌梗死和/或 PCI 的患者中,QP-CMR 的诊断性能与第一通压力灌注 CMR 和定量[15O]H2O PET 的视觉评估相当,可用于检测 FFR 所定义的血流动力学显著性 CAD。
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来源期刊
European Heart Journal - Cardiovascular Imaging
European Heart Journal - Cardiovascular Imaging CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
9.70%
发文量
708
审稿时长
4-8 weeks
期刊介绍: European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology. The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.
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