کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2949445 1577305 2010 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Assessment of Advanced Coronary Artery Disease : Advantages of Quantitative Cardiac Magnetic Resonance Perfusion Analysis
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Assessment of Advanced Coronary Artery Disease : Advantages of Quantitative Cardiac Magnetic Resonance Perfusion Analysis
چکیده انگلیسی

ObjectivesThe purpose of this paper was to compare quantitative cardiac magnetic resonance (CMR) first-pass contrast-enhanced perfusion imaging to qualitative interpretation for determining the presence and severity of coronary artery disease (CAD).BackgroundAdenosine CMR can detect CAD by measuring perfusion reserve (PR) or by qualitative interpretation (QI).MethodsForty-one patients with an abnormal nuclear stress scheduled for X-ray angiography underwent dual-bolus adenosine CMR. Segmental myocardial perfusion analyzed using both QI and PR by Fermi function deconvolution was compared to quantitative coronary angiography.ResultsIn the 30 patients with complete quantitative data, PR (mean ± SD) decreased stepwise as coronary artery stenosis (CAS) severity increased: 2.42 ± 0.94 for <50%, 2.14 ± 0.87 for 50% to 70%, and 1.85 ± 0.77 for >70% (p < 0.001). The PR and QI had similar diagnostic accuracies for detection of CAS >50% (83% vs. 80%), and CAS >70% (77% vs. 67%). Agreement between observers was higher for quantitative analysis than for qualitative analysis. Using PR, patients with triple-vessel CAD had a higher burden of detectable ischemia than patients with single-vessel CAD (60% vs. 25%; p = 0.02), whereas no difference was detected by QI (31% vs. 21%; p = 0.26). In segments with myocardial scar (n = 64), PR was 3.10 ± 1.34 for patients with CAS <50% (n = 18) and 1.91 ± 0.96 for CAS >50% (p < 0.0001).ConclusionsQuantitative PR by CMR differentiates moderate from severe stenoses in patients with known or suspected CAD. The PR analysis differentiates triple- from single-vessel CAD, whereas QI does not, and determines the severity of CAS subtending myocardial scar. This has important implications for assessment of prognosis and therapeutic decision making.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 56, Issue 7, 10 August 2010, Pages 561–569
نویسندگان
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