Ischemic burden by 3-dimensional myocardial perfusion cardiovascular magnetic resonance: comparison with myocardial perfusion scintigraphy.
BACKGROUND
The extent and severity of ischemia on myocardial perfusion scintigraphy (MPS) is commonly used to risk-stratify patients with coronary artery disease. Estimation of ischemic burden by cardiovascular magnetic resonance (CMR) with conventional 2-dimensional myocardial perfusion methods is limited by incomplete cardiac coverage. More recently developed 3-dimensional (3D) myocardial perfusion CMR, however, provides whole-heart coverage. The aim of this study was to compare ischemic burden on 3D myocardial perfusion CMR with (99m)Tc-tetrofosmin MPS.


METHODS AND RESULTS
Forty-five patients who had undergone clinically indicated MPS underwent rest and adenosine stress 3D myocardial perfusion and late gadolinium enhancement CMR. Summed stress and rest scores were calculated for MPS and CMR using a 17-segment model and expressed as a percentage of the maximal possible score. Ischemic burden was defined as the difference between stress and rest scores. 3D myocardial perfusion CMR and MPS agreed in 38 of the 45 patients for the detection of any inducible ischemia. The mean ischemic burden for MPS and CMR was similar (7.5±8.9% versus 6.8±9.5%, respectively, P=0.82) with a strong correlation between techniques (rs=0.70, P<0.001). In a subset of 33 patients who underwent clinically indicated invasive coronary angiography, sensitivities and specificities of the 2 techniques to detect angiographic coronary artery disease were similar (McNemar P=0.45).


CONCLUSIONS
3D myocardial perfusion CMR is an alternative to MPS for detecting the presence and rating the severity of ischemia.
['Jogiya|Roy|R|', 'Morton|Geraint|G|', 'De Silva|Kalpa|K|', 'Reyes|Eliana|E|', 'Hachamovitch|Rory|R|', 'Kozerke|Sebastian|S|', 'Nagel|Eike|E|', 'Underwood|S Richard|SR|', 'Plein|Sven|S|']
D000328:Adult D000368:Aged D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography D003324:Coronary Artery Disease D005260:Female D006321:Heart D006801:Humans D021621:Imaging, Three-Dimensional D019028:Magnetic Resonance Imaging, Cine D008297:Male D008875:Middle Aged D055414:Myocardial Perfusion Imaging D009206:Myocardium D012372:ROC Curve D015203:Reproducibility of Results D012720:Severity of Illness Index
coronary artery disease cardiac-gated single-Photon emission computer-assisted tomography magnetic resonance imaging myocardial infarction myocardial ischemia