1. Diagnostic contributions of cardiac magnetic resonance imaging in patients presenting with elevated troponin, acute chest pain syndrome and unobstructed coronary arteries
- Author
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Dominique Boulmier, Pierre-Axel Lentz, Marc Bedossa, Hervé Le Breton, Guillaume Leurent, B. Langella, A. Larralde, Claire Fougerou, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Myocardite ,MESH: Chi-Square Distribution ,Cardiac magnetic resonance ,Myocardial Infarction ,Contrast Media ,MESH: Takotsubo Cardiomyopathy ,030204 cardiovascular system & hematology ,Coronary Angiography ,Chest pain ,Coronary artery disease ,0302 clinical medicine ,MESH: Up-Regulation ,MESH: Coronary Vessels ,MESH: Syndrome ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,MESH: Myocardial Perfusion Imaging ,Ejection fraction ,biology ,medicine.diagnostic_test ,MESH: Chest Pain ,Syndrome de takotsubo ,Myocardial Perfusion Imaging ,MESH: Magnetic Resonance Imaging, Cine ,Syndrome ,General Medicine ,Syndrome coronaire aigu ,Coronary Vessels ,MESH: Predictive Value of Tests ,Troponin ,Up-Regulation ,3. Good health ,MESH: Myocardial Infarction ,Myocarditis ,MESH: Young Adult ,Acute Disease ,cardiovascular system ,Cardiology ,MESH: Acute Disease ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,Acute coronary syndrome ,France ,Radiology ,medicine.symptom ,Takotsubo syndrome ,Cardiology and Cardiovascular Medicine ,Adult ,Chest Pain ,medicine.medical_specialty ,Magnetic Resonance Imaging, Cine ,Infarctus du myocarde ,MESH: Meglumine ,Young Adult ,03 medical and health sciences ,Meglumine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,MESH: Myocarditis ,Predictive Value of Tests ,Takotsubo Cardiomyopathy ,Cardiac magnetic resonance imaging ,MESH: Contrast Media ,Internal medicine ,Organometallic Compounds ,medicine ,Humans ,MESH: Humans ,Chi-Square Distribution ,business.industry ,MESH: Biological Markers ,MESH: Adult ,MESH: Organometallic Compounds ,medicine.disease ,MESH: Male ,MESH: Prospective Studies ,MESH: Coronary Angiography ,MESH: France ,IRM cardiaque ,biology.protein ,MESH: Troponin ,Myocardial infarction diagnosis ,business ,human activities ,MESH: Female ,Biomarkers - Abstract
International audience; AIMS: Myocardial infarction with unobstructed coronary artery disease represents a serious diagnostic challenge. The role of cardiac magnetic resonance in the management of cardiomyopathies is increasing. We examined the diagnostic contributions of cardiac magnetic resonance in patients presenting with acute chest pain syndrome, elevated serum cardiac troponin concentrations and no significant coronary artery stenoses. METHODS: Over a 3-year period, 107 consecutive patients (mean age 43.5 years; 62% men) presented to our institution with acute onset of chest pain, elevated serum troponin concentration and unobstructed coronary arteries, and underwent 3-tesla cardiac magnetic resonance at a mean delay of 6.9 days. A diagnosis was made based on: wall motion abnormalities and pericardial effusion on cine mode; myocardial oedema on T2-weighted imaging; abnormalities on first-pass perfusion imaging; and late gadolinium enhancement on T1-weighted imaging. RESULTS: Cardiac magnetic resonance was normal in 10.3% of patients and contributed a diagnosis in 89.7%, including myocarditis in 59.9%, stress cardiomyopathy (takotsubo syndrome) in 14% and myocardial infarction in 15.8%. Patients with normal cardiac magnetic resonance had a significantly lower mean peak troponin concentration (2.6ng/mL) than patients with diagnostic cardiac magnetic resonance (9.7ng/mL; P=0.01). CONCLUSION: Cardiac magnetic resonance contributed a diagnosis in nearly 90% of patients presenting with acute chest pain, elevated serum troponin and unobstructed coronary arteries.
- Published
- 2011
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