TY - JOUR
T1 - High-resolution non-contrast free-breathing coronary cardiovascular magnetic resonance ngiography for detection of coronary artery disease
T2 - validation against invasive coronary angiography
AU - Nazir, Muhummad
AU - Bustin, Aurelien
AU - Hajhosseiny, Reza
AU - Yazdani, Momina F.
AU - Ryan, Matt
AU - Vergani, Vittoira
AU - Neji, Radhouene
AU - Kunze, Karl-Philipp
AU - Nicol, Edward
AU - Masci, Pier-Giorgio
AU - Perera, Divaka
AU - Plein, Sven
AU - Chiribiri, Amedeo
AU - Botnar, Rene
AU - Prieto Vasquez, Claudia
N1 - Funding Information:
The authors acknowledge financial support from the Department of Health through the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust and by the NIHR MedTech Co-operative for Cardiovascular Disease at Guy’s and St Thomas’ NHS Foundation Trust. This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0416-20008). The work was also supported by the EPSRC (EP/P001009/1 and EP/P007619/1) and the Wellcome/EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z]. MSN was funded by a NIHR Clinical Lectureship [CL-2019-17-001]. SP is funded by a BHF Chair [CH/16/2/32089]. The views expressed are those of the authors and not necessarily those of the BHF, the DoH, the EPSRC, the NHS, the NIHR, or the Wellcome Trust.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - 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: Forty-five patients (15 female, 62 ± 10 years) with suspected CAD underwent sub-millimeter-resolution (0.6 mm3) 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.
AB - 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: Forty-five patients (15 female, 62 ± 10 years) with suspected CAD underwent sub-millimeter-resolution (0.6 mm3) 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.
KW - Cardiovascular magnetic resonance angiography
KW - Coronary artery disease
KW - Coronary imaging
UR - http://www.scopus.com/inward/record.url?scp=85127947258&partnerID=8YFLogxK
U2 - 10.1186/s12968-022-00858-0
DO - 10.1186/s12968-022-00858-0
M3 - Article
C2 - 35399091
AN - SCOPUS:85127947258
SN - 1097-6647
VL - 24
JO - Journal of Cardiovascular Magnetic Resonance
JF - Journal of Cardiovascular Magnetic Resonance
IS - 1
M1 - 26
ER -