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Verfasst von:Greulich, Simon [VerfasserIn]   i
 André, Florian [VerfasserIn]   i
 Buß, Sebastian Johannes [VerfasserIn]   i
 Katus, Hugo [VerfasserIn]   i
Titel:Value of adenosine stress cardiovascular magnetic resonance in the evaluation of vessels supplying previously infarcted territories
Verf.angabe:Simon Greulich, Maik Backes, Hannah Steubing, Andreas Seitz, Maria Chatzitofi, Philipp Kaesemann, Florian Andre, Sebastian J. Buss, Hugo A. Katus, Heiko Mahrholdt
E-Jahr:2019
Jahr:2019/05/01
Umfang:10 S.
Fussnoten:Gesehen am 10.07.2019
Titel Quelle:Enthalten in: Coronary artery disease
Ort Quelle:London : Lippincott Williams & Wilkins, 1990
Jahr Quelle:2019
Band/Heft Quelle:30(2019), 3, Seite 222-231
ISSN Quelle:1473-5830
Abstract:Background The diagnostic performance of adenosine stress cardiovascular magnetic resonance (CMR) for the detection of significant stenosis in infarct-related arteries is widely unknown. Two different types of perfusion defects can be observed: (a) larger than or (b) equal size as scar. - We hypothesized that: (a) defect>scar predicts significant coronary stenosis, and (b) defect=scar predicts an unobstructed infarct-related artery, and (c) angina symptoms might be of additional value in stratification. - Patients and methods Patients with previous myocardial infarction referred for work-up of myocardial ischemia undergoing adenosine stress CMR were included if they had coronary angiography within 4 weeks of CMR. - Results Two hundred patients with a mean age of 66±11 years, ischemic scars (subendocardial/transmural), and a mean left ventricular ejection fraction of 53% were included. In patients with defect>scar, the positive predictive value was excellent (88%) and typical angina was reported only in the stenosis group (P=0.002). However, patients with defect=scar (with 50% showing subendocardial scar) had a prevalence of 37% for stenosis, yielding a low negative predictive value of 63%. In this group, symptoms of typical angina were independent of stenosis (P=1.0). - Conclusion A perfusion defect larger than scar is highly predictive for significant stenosis in infarct-related arteries. However, more than a third of the patients with perfusion defect of equal size as scar also showed significant coronary stenosis. As half of these patients showed still viable (subendocardial) scars, there is a high-risk of reinfarction. The addition of angina symptoms seems to increase diagnostic accuracy only in patients with perfusion defects larger than scar.
DOI:doi:10.1097/MCA.0000000000000705
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1097/MCA.0000000000000705
 Volltext: https://journals.lww.com/coronary-artery/Abstract/2019/05000/Value_of_adenosine_stress_cardiovascular_magnetic.10.aspx
 DOI: https://doi.org/10.1097/MCA.0000000000000705
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:166892398X
Verknüpfungen:→ Zeitschrift

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