Abstract
BackgroundIn recent years, substantial advances have been made in noninvasive cardiac imaging, including cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR). The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography.MethodsOur objective was to directly compare the diagnostic accuracy of contrast-enhanced whole-heart CCMRA (CE-CCMRA) to dual-source CCTA (DS-CCTA) for the detection of CAD. We prospectively studied 57 symptomatic patients with suspected or known CAD who were scheduled for conventional x-ray coronary angiography. Significant CAD was defined as an x-ray defined diameter reduction of ≥50% in a coronary artery with a reference diameter of ≥1.5 mm.ResultsCE-CCMRA and DS-CCTA were completed in 51 (89%) of 57 patients without complications. The acquisition times of CE-CCMRA and DS-CCTA, respectively, were 9.5 ± 3.1 min and 8.3 ± 1.4 s. On patient-based analysis, the sensitivity, specificity, positive and negative predictive value of CE-CCMRA and DS-CCTA were 93.5% versus 93.5%(P > 0.05), 85% versus 90%(P > 0.05), 90.6% versus 93.5%(P > 0.05), and 89.4% versus 90%(P > 0.05), respectively. The area under the curve (AUC) was 0.89 (95% CI: 0.79 to 0.99) for CE-CCMRA and 0.92 (95% CI: 0.83 to 1.00) for DS-CCTA.ConclusionsDS-CCTA was found to be superior to CE-CCMRA in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known CAD scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution. However, CE-CCMRA and DS-CCTA have similar diagnostic accuracies.
Highlights
Along with economic changes and modernization in developing countries, including China and India, the prevalence of atherosclerotic cardiovascular diseases is increasing rapidly
DS-coronary computed tomography (CT) angiography (CCTA) was found to be superior to contrast enhanced (CE)-coronary cardiovascular magnetic resonance (CMR) angiography (CCMRA) in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known coronary artery disease (CAD) scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution
X-ray angiography has limited utility as a screening tool for detecting coronary artery disease (CAD) due to its costs and invasiveness, Over the past decade, substantial advances have been made in noninvasive cardiac imaging, including the introductions of coronary computed tomography angiography (CCTA) and cardiovascular magnetic resonance imaging (CMR), which have challenged the role of the invasive standard [2, 3]
Summary
Background Along with economic changes and modernization in developing countries, including China and India, the prevalence of atherosclerotic cardiovascular diseases is increasing rapidly. X-ray angiography has limited utility as a screening tool for detecting coronary artery disease (CAD) due to its costs and invasiveness, Over the past decade, substantial advances have been made in noninvasive cardiac imaging, including the introductions of coronary computed tomography angiography (CCTA) and cardiovascular magnetic resonance imaging (CMR), which have challenged the role of the invasive standard [2, 3]. The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography
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