This study evaluated whether first-pass perfusion cardiovascular magnetic resonance
(FP-CMR) could predict the hemodynamic significance of epicardial coronary artery
stenosis as defined by invasively determined fractional flow reserve at coronary angiography.
In 19 patients with known coronary artery disease (CAD), the hemodynamic relevance
of 22 stenoses (mean angiographic severity 73 ± 9%) was determined using fractional
flow reserve measurements (cutoff 0.75). Results were compared with a territorial
index of myocardial perfusion reserve (MPR) derived from FP-CMR. In addition, 9 age-matched
patients with low prevalence of risk factors and without CAD at angiography served
as a control group. A cutoff of 1.5 for MPR separated hemodynamically relevant from
nonrelevant stenoses with a sensitivity and specificity of 92% and 92%, respectively.
The area under the receiver-operator characteristic curve was 0.97. In the patient
group, territories supplied by arteries without significant stenosis (≤50%) showed
a lower MPR compared with the control group (p <0.0001), suggesting the presence of
microvascular dysfunction. In conclusion, FP-CMR may be useful for assessment of the
hemodynamic relevance of angiographically undetermined CAD.
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Article info
Publication history
Accepted:
November 27,
2006
Received in revised form:
November 27,
2006
Received:
July 30,
2006
Identification
Copyright
© 2007 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
