1. Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain
- Author
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Evangelos Giannitsis, J Salatzki, Hugo A. Katus, Marco Ochs, Florian Andre, Deborah Siry, Matthias G Friedrich, Johannes Riffel, and Lukas D. Weberling
- Subjects
Male ,Magnetic Resonance Spectroscopy ,Epidemiology ,Pilot Projects ,Coronary Artery Disease ,Cardiovascular Medicine ,030204 cardiovascular system & hematology ,Coronary Angiography ,Chest pain ,Vascular Medicine ,Biochemistry ,Ventricular Function, Left ,Diagnostic Radiology ,030218 nuclear medicine & medical imaging ,Coronary artery disease ,Electrocardiography ,Medical Conditions ,0302 clinical medicine ,Medicine and Health Sciences ,Coronary Heart Disease ,Prospective Studies ,Myocardial infarction ,Cardiovascular Imaging ,Aged, 80 and over ,Multidisciplinary ,medicine.diagnostic_test ,biology ,Troponin T ,Radiology and Imaging ,Physics ,Angiography ,Classical Mechanics ,Heart ,Middle Aged ,Deformation ,Troponin ,Bioassays and Physiological Analysis ,Cardiovascular Diseases ,Physical Sciences ,Cardiology ,Medicine ,Female ,medicine.symptom ,Research Article ,Adult ,Chest Pain ,medicine.medical_specialty ,Imaging Techniques ,Science ,Pain ,Magnetic Resonance Imaging, Cine ,Research and Analysis Methods ,Angina Pectoris ,Young Adult ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Aged ,Damage Mechanics ,business.industry ,Electrophysiological Techniques ,Biology and Life Sciences ,Proteins ,Magnetic resonance imaging ,medicine.disease ,Myocardial Contraction ,Cytoskeletal Proteins ,ROC Curve ,Medical Risk Factors ,biology.protein ,Feasibility Studies ,Cardiac Electrophysiology ,Clinical Medicine ,business - Abstract
Background Cardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain. Methods and results In 108 patients presenting with acute chest pain, we performed fSENC-CMR after initial clinical assessment in the emergency department. The final clinical diagnosis, for which cardiology-trained physicians used clinical information, serial high-sensitive Troponin T (hscTnT) values and—if necessary—further diagnostic tests, served as the standard of truth. oCAD was defined as flow-limiting CAD as confirmed by coronary angiography with typical angina or hscTnT dynamics. Diagnoses were divided into three groups: 0: non-cardiac, 1: oCAD, 2: cardiac, non-oCAD. The visual analysis of fSENC bull´s eye maps (blinded to final diagnosis) resulted in a sensitivity of 82% and specificity of 87%, as well as a negative predictive value of 96% for identification of oCAD. Both, global circumferential strain (GCS) and global longitudinal strain (GLS) accurately identified oCAD (area under the curve/AUC: GCS 0.867; GLS 0.874; p Conclusion In patients with acute chest pain, myocardial strain imaging with fSENC-CMR may serve as a fast and accurate diagnostic tool for ruling out obstructive coronary artery disease.
- Published
- 2021