Multislice breath-hold spiral magnetic resonance coronary angiography in patients with coronary artery disease: Effect of intravascular contrast medium

Background: Magnetic resonance coronary angiography (MRCA) is one of the most promising tools for noninvasive imaging of coronary arteries without radiation exposure or contrast media administration. However, knowledge about the prognostic value of MRCA is limited. Materials and Methods: The present study included 389 patients with known or suspected coronary artery disease (CAD) underwent clinical cardiac magnetic resonance (CMR) including MRCA imaging. The presence of a significant coronary artery stenosis was defined by visual estimation of ≥50% diameter reduction using targeted MRCA images. Patients were followed up for hard cardiac events (cardiac death or non-fatal myocardial infarction) and major adverse cardiac events (MACE) which also included hospitalization for heart failure and late revascularization (>180 days after the CMR study). Results: The average age was 68±11 years and 48% were male. One hundred and thirty-nine patients had significant stenosis on MRCA. During a median follow-up period of 53.9 months, 23 hard cardiac events and 52 MACE, occurred. Patients with significant coronary artery stenosis had higher rates of hard cardiac events (annual event rate 3.12% versus 0.56%, HR 5.52, 95% CI 2.17 to 14.01, p<0.001) and MACE (annual event rate 6.44% versus 1.83%, HR 3.49, 95% CI 1.98 to 6.14, p<0.001) than those without significant stenosis. Multivariable analyses identified significant coronary artery stenosis as an independent predictor of hard cardiac events (HR 3.35, 95% CI 1.13 to 9.96, p=0.03) and MACE (HR 2.00, 95% CI 1.02 to 3.90, p=0.04). MRCA presented an incremental prognostic value over clinical factors, left ventricular ejection fraction, and myocardial scarring to predict hard cardiac events (p=0.03). Conclusion: Targeted MRCA demonstrated independent and incremental prognostic values to predict future cardiac events in patients with known or suspected CAD. Keywords: Cardiac magnetic resonance imaging; Coronary artery disease; Magnetic resonance coronary angiography; Prognosis

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Assessment of coronary artery disease using 3.0 T magnetic resonance coronary angiography: a national multicenter trial

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/1532-429x-15-s1-e5 ◽

2013 ◽

Vol 15 (S1) ◽

Cited By ~ 7

Author(s):

Qi Yang ◽

Kuncheng Li ◽

Bin Sun ◽

Hong Yun ◽

Lijun Tang ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Magnetic Resonance ◽

Coronary Angiography ◽

Multicenter Trial ◽

Magnetic Resonance Coronary Angiography ◽

3.0 T ◽

Artery Disease

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Abstract 2805: Assessment of Coronary Artery Disease Using Magnetic Resonance Coronary Angiography: A Multicenter Trial

Circulation ◽

10.1161/circ.118.suppl_18.s_778-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Shingo Kato ◽

Hajime Sakuma ◽

Nanaka Ishida ◽

Masaki Ishida ◽

Motonori Nagata ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Magnetic Resonance ◽

Coronary Angiography ◽

Multicenter Study ◽

Sublingual Administration ◽

X Ray ◽

Coronary Mra ◽

Artery Disease ◽

Roc Area

Background: CT coronary angiography is widely used to assess the presence of significant coronary artery disease (CAD). However, CT approach is associated with low but nonnegligible cancer risk. The purpose of this prospective multicenter study was to evaluate the diagnostic performance of coronary magnetic resonance angiography (MRA) in the ability to identify patients with significant CAD compared with coronary angiography. Materials and Methods: The subjects were recruited from 7 institutions. Free breathing coronary MR angiograms covering the entire coronary artery tree were obtained in 138 patients who were suspicious of CAD. Non-contrast enhanced images were acquired with a commercial 1.5T MR imager and five-element cardiac coils after sublingual administration of isosorbide dinitrate. Conventional X-ray coronary angiography was performed within 4 weeks after coronary MRA. MR and X-ray angiograms were sent to a core laboratory for blinded interpretation. Coronary MR angiograms were evaluated by two experienced investigators by using sliding partial MIP reconstruction. Quantitative X-ray coronary angiography analysis was performed with significant CAD defined as luminal narrowing of at least 50% of the diameter. Results: The mean imaging time of coronary MRA was 9.5 ± 4.9 minutes. The prevalence of significant disease on X-ray angiography was 45% (62/138). On a vessel-based analysis, the area under receiver operating characteristic (ROC) curve for the MRA compared with X-ray angiography was 0.90 (95% CI; 0.86 to 0.93). On a patient based analysis, the ROC area was 0.88 (95% CI; 0.81– 0.93). The sensitivity, specificity, positive and negative predictive values of coronary MRA by vessel analysis were 78% (95% CI; 68 – 86%), 86% (82–90%), 60% (51– 69%), 94% (90–96%). These values by patient analysis were 87% (95% CI; 76–94%), 71% (59 – 81%), 71% (59 – 81%), 87% (76–94%). Conclusions: In the current multicenter study using commercial 1.5T MR imagers and sliding partial MIP reconstruction, the diagnostic accuracy of coronary MRA compared to quantitative coronary angiography is good, reflected by an ROC area of 0.88 on patient-based analysis. High negative predictive value indicates that coronary MRA can be used for screening CAD.

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