Coronary Artery DiseaseComparison of Myocardial Transmural Perfusion Gradient by Magnetic Resonance Imaging to Fractional Flow Reserve in Patients With Suspected Coronary Artery Disease
Section snippets
Methods
Patients with suspected or known CAD referred for coronary angiography and FFR measurement were prospectively recruited and underwent CMR perfusion imaging before invasive coronary studies. Exclusion criteria included previous ST-segment elevation infarction, acute coronary syndrome <6 weeks, previous coronary artery bypass graft, impaired left ventricular (LV) function (ejection fraction <40%), estimated glomerular filtration rate <30 ml/min, contraindication to adenosine or gadolinium (Gd)
Results
Of the 76 patients recruited to the study, 5 patients were excluded (1 had claustrophobia, 2 refused to undergo FFR measurement, and 2 with aborted FFR procedure because of vasospasm). The study protocol was completed in 71 patients. Patient demographics are provided in Table 1. A total of 213 coronary arteries were available for analysis. Hemodynamic status changes after adenosine stress both in CMR acquisition and FFR procedure are listed in Table 2. Stressing heart rate was significantly
Discussion
Our study was based on quantitative CMR analysis of myocardial perfusion, and we found that (1) TPG and TPGR with CMR are better than conventional transmural perfusion analysis to detect hemodynamically significant coronary artery stenosis determined by FFR and (2) diagnostic sensitivity of TPGR seems to be superior to TPG with CMR.
Adenosine stress perfusion CMR has been proved to be a useful diagnostic tool in suspected patients with CAD. Quantitative perfusion analysis, such as MBF and MPR,
Disclosures
The authors have no conflicts of interest to disclose.
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Drs. Pan and Huang contributed equally to this work.
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