TY - JOUR
T1 - Diagnostic accuracy of adenosine stress cardiovascular magnetic resonance following acute ST-segment elevation myocardial infarction post primary angioplasty
AU - Wong, Dennis
AU - Leung, Michael
AU - Das, Rajiv
AU - Liew, Gary Y H
AU - Williams, Kerry
AU - Dundon, Benjamin
AU - Molaee, Payman
AU - Teo, Karen S L
AU - Meredith, Ian
AU - Worthley, Matthew
AU - Worthley, Stephen
PY - 2011
Y1 - 2011
N2 - Adenosine stress cardiovascular magnetic resonance (CMR) has been proven an effective tool in detection of reversible ischemia. Limited evidence is available regarding its accuracy in the setting of acute coronary syndromes, particularly in evaluating the significance of non-culprit vessel ischaemia. Adenosine stress CMR and recent advances in semi-quantitative image analysis may prove effective in this area. We sought to determine the diagnostic accuracy of semi-quantitative versus visual assessment of adenosine stress CMR in detecting ischemia in non-culprit territory vessels early after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). METHODS: Patients were prospectively enrolled in a CMR imaging protocol with rest and adenosine stress perfusion, viability and cardiac functional assessment 3 days after successful primary-PCI for STEMI. Three short axis slices each divided into 6 segments on first pass adenosine perfusion were visually and semi-quantitatively analysed. Diagnostic accuracy of both methods was compared with non-culprit territory vessels utilising quantitative coronary angiography (QCA) with significant stenosis defined as >/= 70 . RESULTS: Fifty patients (age 59 +/- 12 years) admitted with STEMI were evaluated. All subjects tolerated the adenosine stress CMR imaging protocol with no significant complications. The cohort consisted of 41 anterior and 59 non anterior infarctions. There were a total of 100 non-culprit territory vessels, identified on QCA. The diagnostic accuracy of semi-quantitative analysis was 96 with sensitivity of 99 , specificity of 67 , positive predictive value (PPV) of 97 and negative predictive value (NPV) of 86 . Visual analysis had a diagnostic accuracy of 93 with sensitivity of 96 , specificity of 50 , PPV of 97 and NPV of 43 . CONCLUSION: Adenosine stress CMR allows accurate detection of non-culprit territory stenosis in patients successfully treated
AB - Adenosine stress cardiovascular magnetic resonance (CMR) has been proven an effective tool in detection of reversible ischemia. Limited evidence is available regarding its accuracy in the setting of acute coronary syndromes, particularly in evaluating the significance of non-culprit vessel ischaemia. Adenosine stress CMR and recent advances in semi-quantitative image analysis may prove effective in this area. We sought to determine the diagnostic accuracy of semi-quantitative versus visual assessment of adenosine stress CMR in detecting ischemia in non-culprit territory vessels early after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). METHODS: Patients were prospectively enrolled in a CMR imaging protocol with rest and adenosine stress perfusion, viability and cardiac functional assessment 3 days after successful primary-PCI for STEMI. Three short axis slices each divided into 6 segments on first pass adenosine perfusion were visually and semi-quantitatively analysed. Diagnostic accuracy of both methods was compared with non-culprit territory vessels utilising quantitative coronary angiography (QCA) with significant stenosis defined as >/= 70 . RESULTS: Fifty patients (age 59 +/- 12 years) admitted with STEMI were evaluated. All subjects tolerated the adenosine stress CMR imaging protocol with no significant complications. The cohort consisted of 41 anterior and 59 non anterior infarctions. There were a total of 100 non-culprit territory vessels, identified on QCA. The diagnostic accuracy of semi-quantitative analysis was 96 with sensitivity of 99 , specificity of 67 , positive predictive value (PPV) of 97 and negative predictive value (NPV) of 86 . Visual analysis had a diagnostic accuracy of 93 with sensitivity of 96 , specificity of 50 , PPV of 97 and NPV of 43 . CONCLUSION: Adenosine stress CMR allows accurate detection of non-culprit territory stenosis in patients successfully treated
UR - http://www.jcmr-online.com/content/pdf/1532-429X-13-62.pdf
U2 - 10.1186/1532-429X-13-62
DO - 10.1186/1532-429X-13-62
M3 - Article
SN - 1097-6647
VL - 13
SP - 1
EP - 8
JO - Journal of Cardiovascular Magnetic Resonance
JF - Journal of Cardiovascular Magnetic Resonance
M1 - 62
ER -