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Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease.

Publication ,  Journal Article
Ahmad, IG; Abdulla, RK; Klem, I; Margulis, R; Ivanov, A; Mohamed, A; Judd, RM; Borges-Neto, S; Kim, RJ; Heitner, JF
Published in: J Nucl Cardiol
April 2016

OBJECTIVES: To assess the diagnostic performance of stress cardiac magnetic resonance (stress CMR) vs stress single-photon emission computed tomography (SPECT) in patients presenting to the emergency department (ED) with chest pain. BACKGROUND: SPECT imaging is the most utilized outpatient procedure in the United States. The diagnostic accuracy of SPECT can be limited by soft tissue attenuation and low spatial resolution. Stress CMR has much higher spatial resolution and without the susceptibility to soft tissue attenuation. METHODS: Eighty-seven patients without a history of CAD presenting to the ED with chest pain were prospectively enrolled. Patients underwent both stress CMR and stress SPECT imaging within 12 hours of presentation. Both the stress imaging tests were interpreted immediately for clinical purposes and coronary angiography was performed if either was abnormal. Patients were considered to have significant CAD if identified by angiography (≥50%) or if a cardiac event (cardiac death, myocardial infarction or revascularization) occurred during follow-up (mean 2.6 ± 1.1 years). RESULTS: Thirty-seven patients were referred for coronary angiography; 29 due to a positive stress test and eight patients for persistent chest pain despite two negative stress tests. There were 22 patients who had significant CAD (≥50%). The remaining patients were followed for 2.6 ± 1.1 years. At the conclusion of the follow-up period, there were four clinical events. The sensitivity, specificity, and diagnostic accuracy of CMR are 85%, 93%, and 89%, respectively. The sensitivity, specificity, and diagnostic accuracy of stress SPECT are 84%, 91%, and 88%, respectively. CONCLUSION: Stress CMR has similar diagnostic accuracy as stress SPECT in diagnosis of CAD.

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Published In

J Nucl Cardiol

DOI

EISSN

1532-6551

Publication Date

April 2016

Volume

23

Issue

2

Start / End Page

287 / 297

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Exercise Test
  • Coronary Artery Disease
  • Cardiovascular System & Hematology
 

Citation

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Ahmad, I. G., Abdulla, R. K., Klem, I., Margulis, R., Ivanov, A., Mohamed, A., … Heitner, J. F. (2016). Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease. J Nucl Cardiol, 23(2), 287–297. https://doi.org/10.1007/s12350-015-0242-0
Ahmad, Ijaz G., Raushan K. Abdulla, Igor Klem, Roman Margulis, Alexander Ivanov, Ambreen Mohamed, Robert M. Judd, Salvatore Borges-Neto, Raymond J. Kim, and John F. Heitner. “Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease.J Nucl Cardiol 23, no. 2 (April 2016): 287–97. https://doi.org/10.1007/s12350-015-0242-0.
Ahmad IG, Abdulla RK, Klem I, Margulis R, Ivanov A, Mohamed A, et al. Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease. J Nucl Cardiol. 2016 Apr;23(2):287–97.
Ahmad, Ijaz G., et al. “Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease.J Nucl Cardiol, vol. 23, no. 2, Apr. 2016, pp. 287–97. Pubmed, doi:10.1007/s12350-015-0242-0.
Ahmad IG, Abdulla RK, Klem I, Margulis R, Ivanov A, Mohamed A, Judd RM, Borges-Neto S, Kim RJ, Heitner JF. Comparison of stress cardiovascular magnetic resonance imaging (CMR) with stress nuclear perfusion for the diagnosis of coronary artery disease. J Nucl Cardiol. 2016 Apr;23(2):287–297.
Journal cover image

Published In

J Nucl Cardiol

DOI

EISSN

1532-6551

Publication Date

April 2016

Volume

23

Issue

2

Start / End Page

287 / 297

Location

United States

Related Subject Headings

  • Tomography, Emission-Computed, Single-Photon
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Exercise Test
  • Coronary Artery Disease
  • Cardiovascular System & Hematology