Erschienen in:
29.10.2015 | Cardiac
Prognostic value of dipyridamole stress cardiac magnetic resonance in patients with known or suspected coronary artery disease: a mid-term follow-up study
verfasst von:
Gianluca Pontone, Daniele Andreini, Erika Bertella, Monica Loguercio, Marco Guglielmo, Andrea Baggiano, Giovanni Donato Aquaro, Saima Mushtaq, Sara Salerni, Paola Gripari, Carmen Rossi, Chiara Segurini, Edoardo Conte, Virginia Beltrama, Marta Giovannardi, Fabrizio Veglia, Andrea Igoren Guaricci, Antonio L. Bartorelli, Piergiuseppe Agostoni, Mauro Pepi, Pier Giorgio Masci
Erschienen in:
European Radiology
|
Ausgabe 7/2016
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Abstract
Objectives
Dipyridamole stress cardiac magnetic resonance (CMR) evaluates the key phases (perfusion and wall motion) of the ischemic cascade. We sought to determine the prognostic value of dipyridamole stress-CMR in consecutive patients symptomatic for chest pain.
Methods
Seven hundred and ninety-three consecutive patients symptomatic for chest pain underwent dipyridamole stress-CMR and were followed up for 810 ± 665 days. Patients were classified in group 1 (no- reversible ischemia), group 2 (stress perfusion defect alone), and group 3 [stress perfusion defect plus abnormal wall motion (AWM)]. End points were "all cardiac events" (myocardial infarction, cardiac death and revascularization) and "hard cardiac events" (all cardiac events excluding revascularization).
Results
One hundred and ninety-five (24 %) all cardiac events and 53 (7 %) hard cardiac events were observed. All and hard cardiac event rates in groups 1, 2, and 3 were 11 %, 49 %, 69 % and 4 %, 8 %, 21 %, respectively, with a higher rate in group 2 vs. group 1 (p<0.01) and group 3 vs. groups 1 and 2 (p<0.01). Multivariate analysis showed the presence of late gadolinium enhancement and stress perfusion defect plus AWM as independent predictors of all and hard cardiac events.
Conclusions
Dipyridamole stress-CMR improves prognostic stratification of patients through differentiation between the different components of the ischemic cascade.
Key Points
• Dipyridamole stress cardiac magnetic resonance helps to assess coronary artery disease.
• Novel technique to study the key phases of myocardial ischemia.
• Combined assessment of perfusion and motion defects.
• Dipyridamole stress imaging has additional value for predicting cardiac events.