Document Type

Article

Publication Date

11-1-2017

Publication Title

The international journal of cardiovascular imaging

Keywords

Aged; Aged, 80 and over; Atrial Fibrillation; Coronary Angiography; Coronary Artery Disease; Coronary Circulation; Female; Heart Rate; Humans; Hyperemia; Magnetic Resonance Imaging; Male; Middle Aged; Myocardial Perfusion Imaging; Predictive Value of Tests; Purines; Pyrazoles; Reproducibility of Results; Time Factors; Vasodilator Agents

Abstract

Cardiovascular magnetic resonance (CMR) perfusion has been established as a useful imaging modality for the detection of coronary artery disease (CAD). However, there are several limitations when applying standard, ECG-gated stress/rest perfusion CMR to patients with atrial fibrillation (AF). In this study we investigate an approach with no ECG gating and a rapid rest/stress perfusion protocol to determine its accuracy for detection of CAD in patients with AF. 26 patients with AF underwent a rapid rest/regadenoson stress CMR perfusion imaging protocol, and all patients had X-ray coronary angiography. An ungated radial myocardial perfusion sequence was used. Imaging protocol included: rest perfusion image acquisition, followed nearly immediately by administration of regadenoson to induce hyperemia, 60 s wait, and stress image acquisition. CMR perfusion images were interpreted by three blinded readers as normal or abnormal. Diagnostic accuracy was evaluated by comparison to X-ray angiography. 21 of the CMR rest/stress perfusion scans were negative, and 5 were positive by angiography criteria. Majority results of the ungated datasets from all of the readers showed a sensitivity, specificity and accuracy of 80, 100 and 96%, respectively, for detection of CAD. An ungated, rapid rest/stress regadenoson perfusion CMR protocol appears to be useful for the diagnosis of obstructive CAD in patients with AF.

Clinical Institute

Cardiovascular (Heart)

Department

Cardiology

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