Authors: Nico Merkle Jochen Wöhrle Thorsten Nusser Olaf Grebe Jochen Spiess Jan Torzewski Vinzenz Hombach
Publish Date: 2009/09/11
Volume: 99, Issue: 1, Pages: 21-28
Abstract
Noninvasive diagnosis of coronary artery disease CAD in women is crucial because of a lower prevalence of CAD in premenopausal women different cardiac risk profile and pattern of CAD lower exercise tolerance and more atypical symptoms compared to men Therefore we tested the diagnostic power of cardiac magnetic resonance first pass perfusion imaging CMRFPPI for the diagnosis of significant coronary stenoses in females versus males256 consecutive patients 77 females and 179 males with atypical or typical chest pain and intermediate risk of CAD were studied by coronary angiography and CMRFPPI 15T Intera CV A threeslice shortaxis perfusion scan with a saturation prepulse was performed during infusion of adenosine and at rest followed by late enhancement imaging for myocardial scar GadoliniumDTPA was administered at 01 mmol/kg body weight Perfusion images were visually analysed coronary stenoses by quantitative coronary angiography Sensitivity specificity and accuracy of CMRFPPI for detection of a significant coronary artery stenosis ≥50 luminal narrowing in the entire group were 913 817 and 886 the corresponding values for females were 909 906 and 908 and for males 914 744 and 877 and in the subgroup of females with suspected primary CAD 833 960 and 936 and for suspected progression 921 714 and 889Diagnostic accuracy of CMRFPPI is very high in women with intermediate risk of CAD and comparable or in part superior to results in males With the advantage of the absence of radiation exposure and high spatial and temporal resolution CMRFPPI has the potential to become the preferred imaging test to select women for coronary angiography
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