Cardiac magnetic resonance performs better in the detection of functionally significant coronary artery Stenosis compared to single-photon emission computed Tomography and Dobutamine stress echocardiography

Kiwamu Kamiya, Mamoru Sakakibara, Naoya Asakawa, Shiro Yamada, Takashi Yoshitani, Hiroyuki Iwano, Hiroshi Komatsu, Masanao Naya, Satoru Chiba, Satoshi Yamada, Osamu Manabe, Yasuka Kikuchi, Noriko Oyama-Manabe, Koji Oba, Hiroyuki Tsutsui

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Abstract

Background: Fractional flow reserve (FFR) measured on catheterization is now widely used for the diagnosis of functional myocardial ischemia in patients with coronary artery disease (CAD). FFR, however, is invasive and carries potential procedural complications. Therefore, the aim of this study was to compare the diagnostic capability in functionally significant stenosis identified on FFR, between cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI), single-photon emission computed tomography MPI (SPECT-MPI), and dobutamine stress echocardiography (DSE) in patients with CAD.

Methods and Results: A total of 25 patients who had at least 1 angiographic stenosis ≥50% on coronary angiography was studied. CMR-MPI, SPECT-MPI and DSE were done before FFR measurement. FFR was measured in all 3 major epicardial coronary arteries. Out of 71 vascular territories excluding 4 territories due to inadequate imaging, 29 (41%) had FFR <0.80. The sensitivity of CMR-MPI was significantly higher than that of SPECT-MPI and DSE (P=0.02 and P=0.001, respectively). The area under the receiver operating characteristic curve (AUC) for CMR-MPI (AUC, 0.92) was significantly greater than for SPECT-MPI (AUC, 0.73; P=0.006) and DSE (AUC, 0.69; P<0.001).

Conclusions: CMR-MPI performed well in the detection of functionally significant stenosis defined according to FFR, and had the highest diagnostic sensitivity among the 3 modalities tested in patients with CAD.

Original languageEnglish
Pages (from-to)2468-2476
Number of pages9
JournalCirculation Journal
Volume78
Issue number10
DOIs
Publication statusPublished - 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kamiya, K., Sakakibara, M., Asakawa, N., Yamada, S., Yoshitani, T., Iwano, H., Komatsu, H., Naya, M., Chiba, S., Yamada, S., Manabe, O., Kikuchi, Y., Oyama-Manabe, N., Oba, K., & Tsutsui, H. (2014). Cardiac magnetic resonance performs better in the detection of functionally significant coronary artery Stenosis compared to single-photon emission computed Tomography and Dobutamine stress echocardiography. Circulation Journal, 78(10), 2468-2476. https://doi.org/10.1253/circj.CJ-13-1454