We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Performance of adenosine 'stress-only' perfusion MRI in patients without a history of myocardial infarction: a clinical outcome study.
- Authors
Lubbers, Daniel; Rijlaarsdam-Hermsen, Dorine; Kuijpers, Dirkjan; Kerkhof, Marjan; Sijens, Paul; Dijkman, Paul; Oudkerk, Matthijs
- Abstract
To assess the diagnostic value of adenosine 'stress-only' myocardial perfusion MR for ischemia detection as an indicator for coronary angiography in patients without a prior myocardial infarction and a necessity to exclude ischemia. Adenosine perfusion MRI was performed at 1.5 T in 139 patients with a suspicion of ischemia and no prior myocardial infarction. After 3 min of adenosine infusion a perfusion sequence was started. Patients with a perfusion defect were referred to coronary angiography (CAG). Patients with a normal perfusion were enrolled in follow-up. Fourteen out of 139 patients (10.1%) had a perfusion defect indicative of ischemia. These patients underwent a coronary angiogram, which showed complete agreement with the perfusion images. 125 patients with a normal myocardial perfusion entered follow-up (median 672 days, range 333-1287 days). In the first year of follow-up one Major Adverse Coronary Event (MACE) occurred and one patient had new onset chest pain with a confirmed coronary stenosis. Reaching a negative predictive value for MACE of 99.2% and for any coronary event of 98.4%. At 2 year follow-up no additional MACE occurred. Sensitivity of adenosine perfusion MR for MACE is 93.3% and specificity and positive predictive value are 100%. Adenosine myocardial perfusion MR for the detection of myocardial ischemia in a 'stress-only' protocol in patients without prior myocardial infarctions, has a high diagnostic accuracy. This fast examination can play an important role in the evaluation of patients without prior myocardial infarctions and a necessity to exclude ischemia.
- Subjects
CARDIAC magnetic resonance imaging; PERFORMANCE evaluation; ADENOSINES; PHYSIOLOGICAL stress; PERFUSION; CORONARY disease; DIAGNOSIS; MYOCARDIAL infarction; HEALTH outcome assessment; ANGIOGRAPHY
- Publication
International Journal of Cardiovascular Imaging, 2012, Vol 28, Issue 1, p109
- ISSN
1569-5794
- Publication type
Article
- DOI
10.1007/s10554-010-9775-0