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Magnetic resonance myocardial perfusion imaging in the diagnosis of functionally significant obstructive coronary

Rebabonye B Pharithi1, Martinus Meela, Thomas Kropmans

  • 1Department of Cardiology, St Lukes hospital, Freshford Road, Kilkenny, Republic of Ireland. rpharithi@gmail.com.

Systematic Reviews
|June 3, 2014
PubMed

Insights

Cardiac magnetic resonance (CMR) imaging may be a non-invasive alternative to fractional flow reserve (FFR) for detecting obstructive coronary artery disease (CAD). This review assesses CMR

Area of Science:

  • Cardiovascular Imaging
  • Diagnostic Accuracy
  • Interventional Cardiology

Background:

  • Cardiac magnetic resonance (CMR) myocardial perfusion imaging is a potential non-invasive method for diagnosing obstructive coronary artery disease (CAD).
  • It is being considered as an alternative to pressure wire-guided fractional flow reserve (FFR) for assessing haemodynamic significance.

Purpose of the Study:

  • To systematically review and determine the diagnostic accuracy of CMR in detecting haemodynamically significant obstructive CAD.
  • To compare the diagnostic performance of CMR against FFR.

Main Methods:

  • Systematic review of diagnostic test accuracy studies comparing CMR and FFR.
  • Literature search of multiple databases (Medline, PubMed, EMBASE, Google Scholar, Scopus, Cochrane) up to November 2013.
  • Quality assessment using QUADAS-2 tool; data extraction and analysis using STATA 13 (xtmelogit) for pooled sensitivity and specificity.
  • Generation of forest plots and summary receiver operating characteristic curves.
  • Sub-group analyses based on CMR image quality (Tesla) and analysis basis (coronary territory vs. patient) at different FFR cutoffs (≤0.75, ≤0.8).

Main Results:

  • This section is to be populated once the systematic review is completed and results are available.

Conclusions:

  • This systematic review aims to establish whether CMR is a suitable non-invasive alternative to FFR for diagnosing significant obstructive CAD.
  • The review will also evaluate the diagnostic accuracy of specific CMR techniques at varying FFR thresholds.
Abstract

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