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Reliable exclusion of prognostically significant coronary disease in left ventricular dysfunction by cardiac MRI

Lookup NU author(s): Dr Jenifer Crilley, Emeritus Professor Amritpal Hungin


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© 2016 The Royal College of Radiologists Aim To assess the ability of cardiac magnetic resonance (CMR) to exclude prognostically significant coronary artery disease (CAD) in patients with left ventricular systolic dysfunction (LVSD). Materials and methods A cohort of patients who underwent both X-ray angiography and CMR since 2006 was reviewed retrospectively. Records of those with European criteria for LVSD (left ventricular ejection fraction [LVEF] <50% or LV end-diastolic volume index [LVEDVI] ≥97 ml/m2) on CMR or transthoracic echo were analysed. The presence and extent of subendocardial late gadolinium enhancement (LGE) was recorded with the 17-segment model. The degree of coronary stenosis at X-ray angiography was assessed visually and significant disease defined as stenosis of the LMS ≥50%, or proximal left anterior descending ≥75%, or ≥70% in two main coronary vessels. Results One hundred and sixteen patients were included. The mean age was 64 years and 78% were male. The mean LVEF was 40%. The prevalence of prognostic CAD was 47%. The presence of subendocardial LGE detected prognostically significant CAD with a sensitivity of 100% (95% CI: 94–100%) with no false-negative results. Conclusions The absence of subendocardial LGE on CMR reliably excludes prognostic CAD in patients with LVSD.

Publication metadata

Author(s): Thompson ACM, Crilley JG, Wilson DW, Hungin APS, Fuat A, Murphy JJM

Publication type: Article

Publication status: Published

Journal: Clinical Radiology

Year: 2017

Volume: 72

Issue: 2

Pages: 159-164

Print publication date: 01/02/2017

Online publication date: 02/11/2016

Acceptance date: 10/10/2016

ISSN (print): 0009-9260

ISSN (electronic): 1365-229X

Publisher: W.B. Saunders Ltd


DOI: 10.1016/j.crad.2016.10.006

PubMed id: 27816171


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