Hyperventilation strain CMR imaging in patients with acute chest pain

• Verfasst von: Siry, Deborah [VerfasserIn]
• Verfasst von: Riffel, Johannes [VerfasserIn]
• Verfasst von: Salatzki, Janek [VerfasserIn]
• Verfasst von: André, Florian [VerfasserIn]
• Verfasst von: Ochs, Marco [VerfasserIn]
• Verfasst von: Weberling, Lukas D. [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Friedrich, Matthias [VerfasserIn]
• Titel: Hyperventilation strain CMR imaging in patients with acute chest pain
• Verf.angabe: Deborah Siry, Johannes H. Riffel, Janek Salatzki, Florian Andre, Marco Ochs, Lukas D. Weberling, Evangelos Giannitsis, Hugo A. Katus, Matthias G. Friedrich
• E-Jahr: 2022
• Jahr: 09 August 2022
• Umfang: 10 S.
• Fussnoten: Gesehen am 07.12.2022
• Titel Quelle: Enthalten in: Scientific reports
• Ort Quelle: [London] : Macmillan Publishers Limited, part of Springer Nature, 2011
• Jahr Quelle: 2022
• Band/Heft Quelle: 12(2022), Artikel-ID 13584, Seite 1-10
• ISSN Quelle: 2045-2322
• DOI: doi:10.1038/s41598-022-17856-y
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cardiology
• Sach-SW: Medical research
• K10plus-PPN: 1826453806

Abstract

In patients with suspected acute coronary syndrome high-sensitivity cardiac tropnonin T is used for rapid patient triage. Some acute coronary syndrome patients assigned to the observe zone based on high-sensitivity cardiac troponin T after 1 h require further diagnostic testing. Fast-strain encoded CMR imaging with breathing maneuvers may accelerate diagnostic work-up and identify patients suffering from acute coronary syndrome. Patients presenting with acute chest pain (high-sensitivity cardiac troponin T level 5-52 ng/L) were prospectively enrolled (consecutive sampling, time of recruitment: 09/18-06/19). Fast-strain-encoded imaging was performed within the 1-h timeframe (0 h/1 h algorithm) prior to 2nd high-sensitivity troponin T lab results. Images were acquired at rest as well as after 1-min of hyperventilation followed by a short breath-hold. In 108 patients (59 male; mean age: 57 ± 17y) the mean study time was 17 ± 3 min. An abnormal strain response after the breathing maneuver (persistent/increased/new onset of increased strain rates) correctly identified all 17 patients with a high-sensitivity troponin T dynamic (0 h/1 h algorithm) and explanatory significant coronary lesions, while in 86 patients without serologic or angiographic evidence for severe coronary artery disease the strain response was normal (sensitivity 100%, specificity 94.5%; 5 false positive results). The number of dysfunctional segments (strain > − 10%) proved to be a quantifiable marker for identifying patients with acute coronary syndrome. In patients with suspected acute coronary syndrome and inconclusive initial high-sensitivity troponin T, fast-strain-encoded imaging with a breathing maneuver may safely and rapidly identify patients with acute coronary syndrome, without the need for vasodilators, stress, or contrast agents.