Assessment of Multivessel Coronary Artery Disease Using Cardiovascular Magnetic Resonance Pixelwise Quantitative Perfusion Mapping

• Published in: JACC. Cardiovascular imaging 2020-12, Vol.13 (12), p.2546-2557
• Main Authors: Kotecha, Tushar, Chacko, Liza, Chehab, Omar, O’Reilly, Nanci, Martinez-Naharro, Ana, Lazari, Jonathan, Knott, Kristopher D., Brown, James, Knight, Daniel, Muthurangu, Vivek, Hawkins, Philip, Plein, Sven, Moon, James C., Xue, Hui, Kellman, Peter, Rakhit, Roby, Patel, Niket, Fontana, Marianna
• Format: Article
• Language: English
• Subjects: adenosine stress; cardiovascular magnetic resonance; coronary artery disease; myocardial blood flow
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2020.06.041

The authors sought to compare the diagnostic accuracy of quantitative perfusion maps to visual assessment (VA) of first-pass perfusion images for the detection of multivessel coronary artery disease (MVCAD). VA of first-pass stress perfusion cardiac magnetic resonance (CMR) may underestimate ischemia in MVCAD. Pixelwise perfusion mapping allows quantitative measurement of regional myocardial blood flow, which may improve ischemia detection in MVCAD. One hundred fifty-one subjects recruited at 2 centers underwent stress perfusion CMR with myocardial perfusion mapping, and invasive coronary angiography with coronary physiology assessment. Ischemic burden was assessed by VA of first-pass images and by quantitative measurement of stress myocardial blood flow using perfusion maps. In patients with MVCAD (2-vessel [2VD] or 3-vessel disease [3VD]; n = 95), perfusion mapping identified significantly more segments with perfusion defects (median segments per patient 12 [interquartile range (IQR): 9 to 16] by mapping vs. 8 [IQR: 5 to 9.5] by VA; p