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High-resolution non-contrast free-breathing coronary cardiovascular magnetic resonance angiography for detection of coronary artery disease: validation against invasive coronary angiography

Year: 2022
Type: article
Abstract: BACKGROUND: Coronary artery disease (CAD) is the single most common cause of death worldwide. Recent technological developments with coronary cardiovascular magnetic resonance angiography (CCMRA) allow high-resolution free-breathing imaging of the coronary arteries at submillimeter resolution without contrast in a predictable scan time of ~ 10 min. The objective of this study was to determine the diagnostic accuracy of high-resolution CCMRA for CAD detection against the gold standard of invasive coronary angiography (ICA). METHODS: ) non-contrast CCMRA at 1.5T in this prospective clinical study from 2019-2020. Prior to CCMR, patients were given an intravenous beta blockers to optimize heart rate control and sublingual glyceryl trinitrate to promote coronary vasodilation. Obstructive CAD was defined by lesions with ≥ 50% stenosis by quantitative coronary angiography on ICA. RESULTS: The mean duration of image acquisition was 10.4 ± 2.1 min. On a per patient analysis, the sensitivity, specificity, positive predictive value and negative predictive value (95% confidence intervals) were 95% (75-100), 54% (36-71), 60% (42-75) and 93% (70-100), respectively. On a per vessel analysis the sensitivity, specificity, positive predictive value and negative predictive value (95% confidence intervals) were 80% (63-91), 83% (77-88), 49% (36-63) and 95% (90-98), respectively. CONCLUSION: As an important step towards clinical translation, we demonstrated a good diagnostic accuracy for CAD detection using high-resolution CCMRA, with high sensitivity and negative predictive value. The positive predictive value is moderate, and combination with CMR stress perfusion may improve the diagnostic accuracy. Future multicenter evaluation is now required.
DOI: 10.1186/s12968-022-00858-0
Authors: Muhummad Sohaib Nazir, Aurélien Bustin, Reza Hajhosseiny, Momina Yazdani, Matthew Ryan, Vittoria Vergani, Radhouene Neji, Karl P. Kunze, Edward Nicol, Pier Giorgio Masci, Divaka Perera, Sven Plein, Amedeo Chiribiri, René Botnar, Claudia Prieto
Institutions: St Thomas' Hospital, King's College London, British Heart Foundation, National Institute for Health and Care Research, Guy's and St Thomas' NHS Foundation Trust, Royal Brompton Hospital, University of Leeds, Pontificia Universidad Católica de Chile
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,680
Funders: Wellcome Trust, National Institute for Health and Care Research, British Heart Foundation, Engineering and Physical Sciences Research Council, Research Trainees Coordinating Centre, Research for Patient Benefit Programme
Awards: King's College London Medical Engineering Centre of Research Excellence, Novel Cardiac MRI methods for the diagnosis of coronary artery disease compared to PET imaging and Invasive Coronary Angiography: A cohort study and health economic evaluation for patient benefit., Self-Navigated Multi-Contrast And Quantitative Whole Heart 3D Magnetic Resonance Imaging, G3171527865, SmartHeart: Next-generation cardiovascular healthcare via integrated image acquisition, reconstruction, analysis and learning, The BHF Chair of Cardiovascular Imaging, G5847502682, G6688696953, G7804416473, G8938313879
OpenAlex ID: W4223494532
FWCI: 3.345
Cites: 30
Cited by: 33
Related to: 10