Reliable exclusion of prognostically significant coronary disease in left ventricular dysfunction by cardiac MRI

Thompson, A.C.M.; Crilley, J.G.; Wilson, D.W.; Hungin, A.P.S.; Fuat, A.; Murphy, J.J.M.

Abstract

Aim To assess the ability of cardiac magnetic resonance (CMR) to exclude prognostically significant coronary artery disease (CAD) in patients with left ventricular systolic dysfunction (LVSD). Materials and methods A cohort of patients who underwent both X-ray angiography and CMR since 2006 was reviewed retrospectively. Records of those with European criteria for LVSD (left ventricular ejection fraction [LVEF] <50% or LV end-diastolic volume index [LVEDVI] ≥97 ml/m2) on CMR or transthoracic echo were analysed. The presence and extent of subendocardial late gadolinium enhancement (LGE) was recorded with the 17-segment model. The degree of coronary stenosis at X-ray angiography was assessed visually and significant disease defined as stenosis of the LMS ≥50%, or proximal left anterior descending ≥75%, or ≥70% in two main coronary vessels. Results One hundred and sixteen patients were included. The mean age was 64 years and 78% were male. The mean LVEF was 40%. The prevalence of prognostic CAD was 47%. The presence of subendocardial LGE detected prognostically significant CAD with a sensitivity of 100% (95% CI: 94–100%) with no false-negative results. Conclusions The absence of subendocardial LGE on CMR reliably excludes prognostic CAD in patients with LVSD.

Citation

Thompson, A., Crilley, J., Wilson, D., Hungin, A., Fuat, A., & Murphy, J. (2017). Reliable exclusion of prognostically significant coronary disease in left ventricular dysfunction by cardiac MRI. Clinical Radiology, 72(2), 159-164. https://doi.org/10.1016/j.crad.2016.10.006

• Journal Article Type: Article
• Acceptance Date: Oct 10, 2016
• Online Publication Date: Nov 2, 2016
• Publication Date: Feb 1, 2017
• Deposit Date: Nov 18, 2016
• Publicly Available Date: Nov 2, 2017
• Journal: Clinical Radiology
• Print ISSN: 0009-9260
• Electronic ISSN: 1365-229X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 72
• Issue: 2
• Pages: 159-164
• DOI: https://doi.org/10.1016/j.crad.2016.10.006
• Public URL: https://durham-repository.worktribe.com/output/1371501