Multimodality CMR detection of coronary artery disease in patients with heart failure and depressed systolic function: superiority of coronary MRI compared to late gadolinium enhancement
© Hauser et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
Heart failure (HF) with depressed systolic function is increasingly prevalent in the United States with coronary artery disease (CAD) the most common etiology. Definitive determination of an ischemic vs. non-ischemic etiology of HF often requires invasive x-ray coronary angiography. Both coronary magnetic resonance imaging (cMRI) and late gadolinium enhancement (LGE) have shown promise in the non-invasive detection of CAD in HF patients.
We hypothesized that the combination of cMRI and LGE would have superior performance to either test alone.
We studied a consecutive series of patients with depressed left ventricular ejection fraction (≤ 40%) who underwent both cMRI and LGE. cMRI evidence of CAD in a territory that matched the wall motion abnormalities or subendocardial LGE was considered evidence of CAD. For combined assessment, evidence of CAD by either test was considered a positive result.
Test characteristics for the detection of CAD
(N = 97)
(N = 104)
(N = 106)
Positive Predictive Value
Negative Predictive Value
Among patients with depressed LVEF, cMRI is superior to LGE alone or a combined assessment in characterizing ischemic vs. non-ischemic etiologies of HF with depressed systolic function.
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