Visualization and functional assessment of proximal and middle left anterior descending coronary stenoses in humans

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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
07:21

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Published on: February 13, 2011

W G Hundley1, C A Hamilton, G D Clarke

  • 1Department of Internal Medicine, The Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA. ghundley@wfubmc.edu

Circulation
|June 29, 1999
PubMed

Insights

Magnetic resonance imaging (MRI) can accurately detect significant left anterior descending (LAD) artery stenosis by measuring coronary flow reserve. This noninvasive technique shows high sensitivity and specificity, aiding in identifying patients who benefit from coronary artery bypass grafting.

Area of Science:

  • Cardiovascular Imaging
  • Noninvasive Diagnostic Techniques
  • Interventional Cardiology

Background:

  • Coronary artery bypass grafting (CABG) is vital for patients with severe coronary artery narrowing, especially in the left anterior descending (LAD) artery.
  • Coronary flow reserve (CFR) measurement identifies functionally significant LAD stenoses.
  • The diagnostic utility of magnetic resonance imaging (MRI) for detecting significant LAD stenoses remains unclear.

Purpose of the Study:

  • To evaluate the effectiveness of MRI in assessing coronary flow reserve (CFR) and detecting significant stenoses in the LAD artery.
  • To compare MRI-derived CFR measurements with invasive assessments.

Main Methods:

  • Thirty patients underwent MRI for LAD visualization and CFR measurement at rest and during adenosine-induced hyperemia.
  • Contrast coronary angiography and intracoronary Doppler assessments were performed for comparison.
  • Quantitative coronary angiography (QCA) was used to assess stenosis severity.

Main Results:

  • MRI-assessed CFR showed a statistically significant correlation with QCA stenosis severity and invasive CFR measurements (P<0.0001).
  • MRI demonstrated 100% sensitivity and 83% specificity for detecting >70% stenosis in the distal left main or proximal/middle LAD arteries compared to QCA.
  • Noninvasive MRI CFR correlated well with invasive Doppler-derived CFR.

Conclusions:

  • Noninvasive MRI measurement of CFR is a sensitive and specific method for identifying significant LAD stenoses.
  • MRI-based CFR assessment can help identify patients who may benefit from CABG surgery.
  • This technique offers a promising noninvasive approach for evaluating coronary artery disease.
Abstract

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