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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

BAEZA, Ricardo et al. Stress Perfusion Cardiac Magnetic Resonance Imaging: Clinical usefulness compared to conventional coronary angiography.. Rev Chil Cardiol [online]. 2010, vol.29, n.2, pp.171-176. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602010000200001.

Background: Cardiovascular magnetic resonance (CMR) is a non invasive and non ionizing imaging tool that allows a complete cardiovascular evaluation. One of its advantages is the ability to analyze myocardial perfusión with and without stress.   Aim: To show our experience using stress perfusión CMR (SPCMR), its correlation with conventional coronary angiography (CCA) and cardiovascular events.   Methods: We retrospectively included in the analysis all patients referred to our institution to undergo a SPCMR since January 2007 to April 2009. In all patients we performed a complete evaluation including anatomic, left ventricular function, adenosine stress perfusión and viability study. All the studies were performed in a 1.5 T scanner and 10 seconds breath-hold. Stress perfusión was performed alter iv adenosine bolus (140 ug/Kg/min). Eight minutes after the stress, the rest phase was performed. Viability analysis was done after the iv injection of gadolinium based contrast (0.15 mMol/ kg). A positive SPCMR was considered in those with mismatch areas between stress and rest phases. In those patients who underwent a CCA, we correlated the SP-CMR findings with the presence and location of stenoses equal or greater than 70% as significant.   Results: We included 71 patients during the mentioned period. Indication for SPCMR were heart failure and viability study (64%); coronary ischemia (36%). Main baseline characteristics were: Male 7%; age 9 ±7 years; diabetes 17%; hypertension 13%; previous family history for CAD 15%; and tobacco 20%. Mean left ventricular ejection fraction was 53±7 %. Mean time to complete the exam was 50±5 minutes. There were not adverse reactions to contrast or adenosine. Thirty one patients (42%) underwent CCA. All patients with stenoses greater than 70% had a positive SPCMR. Agreement between CCA and SPCMR for ischemia location was 90%.   Conclusion: SPCMR is feasible, safe and reliable in patients with suspected ischemia. Sensitivity, specificity and predictive values make this non invasive technique a very appealing tool in clinical practice.

Keywords : Cardiac Magnetic Resonance; coronary angiography.

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