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
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概要
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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.
- 一般社団法人 日本循環器学会の論文
著者
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Chiba Satoru
Department Of Cardiovascular Medicine Kushiro Rousai Hospital
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Yamada Satoshi
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Naya Masanao
Department Of Cardiology Hokkaido University Hospital
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Yoshitani Takashi
Department Of Cardiovascular Medicine Kushiro-shi Ishikai Hospital
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Sakakibara Mamoru
Department of Cardiology, Ikegami General Hospital Heart Center
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Yamada Shiro
Department Of Basic Pathology National Defense Medical College
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Komatsu Hiroshi
Department Of Anesthesiology Hiraka General Hospital
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Oba Koji
Translational Research And Clinical Trial Center Hokkaido University Hospital
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Kamiya Kiwamu
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Oyama-Manabe Noriko
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital
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MANABE Osamu
Department of Applied Chemistry, Faculty of Engineering, Nagasaki University
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Asakawa Naoya
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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TSUTSUI Hiroyuki
Department of Cardiology, Iizuka Hospital
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Yoshitani Takashi
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Iwano Hiroyuki
Division of Cardiology, University of Mississippi Medical Center
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Kikuchi Yasuka
Department of Diagnostic and Interventional Radiology, Hokkaido University Graduate School of Medicine
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Oyama-Manabe Noriko
Department of Diagnostic and Interventional Radiology, Hokkaido University Graduate School of Medicine
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