ASSESSMENT OF PATIENTS WITH KNOWN CORONARY ARTERY DISEASE BY STRESS CARDIAC MRI.

Abstract

Background: Signicant coronary artery lesions can be detected by evaluating regional myocardial perfusion by Cardiac MRI (CMR). This study aims to determine the usefulness of this technique in “known” patients of coronary artery disease (CAD). Our study aims at describing CMR featur Methods: es of CAD, including CINE and perfusion imaging. Stress perfusion imaging with pharmacologic stress (Adenosine) was performed on 22 patients with known CAD. These patients also underwent Catheter angiography (CAG). A total of 66 coronary territories were assessed for perfusion abnormalities and corresponding CAG ndings. Regional wall motion abnormalities were Results: seen in 28(42.4%) coronary territories and regional myocardial thinning in 11(16%) territories. Hypokinesia (68%) was the most commonly observed wall motion abnormality. Wall motion abnormality was present in most (91%; n=20) of the infarcted territories and some (18.2%;n=8) of the non-infarct territories. Regional myocardial thinning was present in some of the infarcted (27%; n=6) territories and none of the non-infarcted territories. The mean wall thickness in infarct territories was 5.1mm±0.4 and in non-infarct territories was 7.1mm±0.6. T2/STIR hyperintensity was present in 5 (23%) infarct related coronary territories and none of the non-infarcted territories. In all 5 cases, MRI was done within 10 days of symptom onset. 32 (49%) coronary territories showed perfusion defect on stress imaging, with 23 (35%) of them showing a matched defect on rest perfusion and 9 (14%) showing stress inducible perfusion defect. No perfusion defect was seen in 34(51%) territories. All 22 patients underwent CAG. 15patients had signicant disease (>70%) in a single vessel, 5 had in two vessels and none had in all the three vessels.2 patients had non-occlusive coronaries (MINOCA). Using CAG as gold standard, the sensitivity of stress perfusion CMR in detecting signicant CAD in non-infarct territory in these patients was 70%, with a specicity of 94% and accuracy of 88.3%. Visual analysis of rst-pass gadolinium CMR perfusion images to detect reg Conclusion: ional myocardial perfusion defect has a moderate sensitivity and high specicity for diagnosing signicant obstructive CAD in non-infarct related coronaries, as compared to CAG.