- Oral presentation
- Open Access
Combined stress myocardial perfusion and late gadolinium enhancement imaging by cardiac magnetic resonance provides robust prognostic data to cardiac events
© Coelho-Filho et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Myocardial Perfusion
- Cardiac Magnetic Resonance
- Myocardial Perfusion Imaging
- Late Gadolinium Enhancement
- Major Adverse Cardiovascular Event
Cardiac Magnetic Resonance (CMR) can obtain accurate information regarding ventricular function, viability, and can also detect evidence of ischemia by myocardial perfusion imaging. While each of these components may prognosticate cardiac patients from a different pathophysiologic perspective, we seek to determine the relative strengths of association of each of these components of CMR with hard cardiac events.
We further hypothesize that evidence of myocardial ischemia can provide incremental prognostic information beyond LVEF and presence of myocardial scar.
We performed stress CMR on 473 patients (196 females, mean age 56 ± 12 years) with an intermediate pre-test likelihood of CAD referred for assessment of myocardial ischemia. Rest and vasodilator stress CMR myocardial perfusion were performed using a 0.07-0.1 mmol/Kg bolus infusion of gadolinium, followed by cine function imaging and late gadolinium enhancement (LGE) 10 minutes after a cumulative dose of 0.15-0.2 mmol/Kg of gadolinium. CMR myocardial perfusion images were interpreted for reversible myocardial perfusion defect (RevPD) using the 16-segment nomenclature and LGE was graded separately. The readers were blinded to all clinical outcomes.
Univariable association with MACE in the study group
MACE (n = 39)
HR 95% CI
LVEF, per 10%
LC Mass Index
Stress perfusion defect
Best final model for MACE by stepwise forward selection
Presence of LGE
Reversible myocardial perfusion as evidence of myocardial ischemia provides strong and incremental prognostic information to patients presented with an intermediate likelihood of CAD. In addition, combining myocardial perfusion imaging and late gadolinium enhancement imaging, a negative CMR study portends an excellent (99%) negative event rate for cardiac death.
This article is published under license to BioMed Central Ltd.