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Comprehensive multimodality characterization of hemodynamically significant and non-significant coronary lesions

Leif-Christopher Engel1,2,3, Ulf Landmesser1,2, Youssef S Abdelwahed1

  • 1Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Klinik für Kardiologie, Berlin, Germany.

Plos One
|February 1, 2020
PubMed

Insights

Molecular imaging can characterize coronary lesions. Albumin-binding probe-enhanced cardiac MRI shows signal enhancement in hemodynamically significant coronary lesions, unlike T1-weighted MRI.

Area of Science:

  • Cardiovascular imaging
  • Medical diagnostics
  • Biomedical engineering

Background:

  • Limited understanding of molecular imaging parameters for characterizing coronary lesions.
  • Need for methods to differentiate hemodynamically significant from non-significant coronary lesions.

Purpose of the Study:

  • To describe and differentiate parameters between hemodynamically significant and non-significant coronary lesions.
  • To evaluate invasive and non-invasive imaging measures for coronary lesion characterization.

Main Methods:

  • Clinical study involving patients with suspected coronary artery disease (CAD).
  • Utilized native T1-weighted CMR, gadofosveset-enhanced CMR, and invasive coronary angiography.
  • Optical coherence tomography (OCT) assessed plaque type; quantitative flow reserve (QFR) determined functional significance (QFR <0.8).

Main Results:

  • Gadofosveset-enhanced CMR showed significantly higher signal enhancement in hemodynamically significant lesions (QFR <0.8) compared to non-significant lesions.
  • No significant difference in signal enhancement was observed on native T1-weighted CMR.
  • Vulnerable plaque (OCT-assessed) was more frequently associated with hemodynamically significant lesions.

Conclusions:

  • Signal enhancement on albumin-binding probe-enhanced CMR is associated with hemodynamically relevant coronary lesions.
  • Native T1-weighted CMR did not show significant differences for lesion characterization.
  • This pilot study highlights the potential of specific molecular imaging probes in assessing coronary lesion significance.
Abstract

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