Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction
The utility of contrast MRI for assessing myocardial viability in stable coronary artery disease (CAD) with left ventricular dysfunction is uncertain. We therefore performed cine and contrast MRI in 24 stable patients with CAD and regional contractile abnormalities and compared MRI findings with res...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1998-12, Vol.98 (24), p.2687-2694 |
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| creator | RAMANI, K JUDD, R. M HOLLY, T. A PARRISH, T. B RIGOLIN, V. H PARKER, M. A CALLAHAN, C FITZGERALD, S. W BONOW, R. O KLOCKE, F. J |
| description | The utility of contrast MRI for assessing myocardial viability in stable coronary artery disease (CAD) with left ventricular dysfunction is uncertain. We therefore performed cine and contrast MRI in 24 stable patients with CAD and regional contractile abnormalities and compared MRI findings with rest-redistribution 201Tl imaging and dobutamine echocardiography.
Delayed MRI contrast enhancement patterns were examined from 3 to 15 minutes after injection of 0.1 mmol/kg IV gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Comparable MRI and 201Tl basal and midventricular short-axis images were subdivided into 6 segments. Segments judged nonviable by quantitative and qualitative assessment of 201Tl scans showed persistent, systematically greater MRI contrast signal intensity than segments judged viable (P |
| doi_str_mv | 10.1161/01.CIR.98.24.2687 |
| format | Article |
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Delayed MRI contrast enhancement patterns were examined from 3 to 15 minutes after injection of 0.1 mmol/kg IV gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Comparable MRI and 201Tl basal and midventricular short-axis images were subdivided into 6 segments. Segments judged nonviable by quantitative and qualitative assessment of 201Tl scans showed persistent, systematically greater MRI contrast signal intensity than segments judged viable (P</=0.002). Delayed contrast hyperenhancement also occurred in segments judged nonviable by dobutamine echocardiography (P</=0.03). The presence or absence of hyperenhancement correlated most closely with nonviability and viability, respectively, in segments that were akinetic or dyskinetic under resting conditions (83% concordance with 201Tl in both cases). In segments with resting hypokinesis, 58% of segments showing hyperenhancement were judged viable by 201Tl and may have represented an admixture of scar tissue and viable myocardium.
Delayed (by 3 to 15 minutes) hyperenhancement of Gd-DTPA contrast-enhanced MRI images occurs frequently in dysfunctional areas of the left ventricle in patients with stable CAD. Hyperenhancement is associated with nonviability by rest-redistribution 201Tl scintigraphy and dobutamine echocardiography, particularly in regions exhibiting resting akinesis/dyskinesis. The absence of hyperenhancement correlates with radionuclide and echocardiographic determinations of viability, regardless of resting contractile function.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.98.24.2687</identifier><identifier>PMID: 9851954</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiomyopathies - diagnosis ; Cardiomyopathies - diagnostic imaging ; Cardiovascular system ; Contrast Media ; Coronary Disease - diagnosis ; Coronary Disease - diagnostic imaging ; Dobutamine ; Female ; Gadolinium DTPA ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Myocardial Contraction - physiology ; Polylysine ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Thallium Radioisotopes ; Tomography, Emission-Computed, Single-Photon ; Ultrasonography ; Ventricular Dysfunction, Left - diagnosis ; Ventricular Dysfunction, Left - diagnostic imaging</subject><ispartof>Circulation (New York, N.Y.), 1998-12, Vol.98 (24), p.2687-2694</ispartof><rights>1999 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Dec 15, 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-d2f09edbe91f85f328add53055d4dc3a16e8ee912873878d8cde575c02a9ac6b3</citedby><cites>FETCH-LOGICAL-c437t-d2f09edbe91f85f328add53055d4dc3a16e8ee912873878d8cde575c02a9ac6b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1617525$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9851954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>RAMANI, K</creatorcontrib><creatorcontrib>JUDD, R. M</creatorcontrib><creatorcontrib>HOLLY, T. A</creatorcontrib><creatorcontrib>PARRISH, T. B</creatorcontrib><creatorcontrib>RIGOLIN, V. H</creatorcontrib><creatorcontrib>PARKER, M. A</creatorcontrib><creatorcontrib>CALLAHAN, C</creatorcontrib><creatorcontrib>FITZGERALD, S. W</creatorcontrib><creatorcontrib>BONOW, R. O</creatorcontrib><creatorcontrib>KLOCKE, F. J</creatorcontrib><title>Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>The utility of contrast MRI for assessing myocardial viability in stable coronary artery disease (CAD) with left ventricular dysfunction is uncertain. We therefore performed cine and contrast MRI in 24 stable patients with CAD and regional contractile abnormalities and compared MRI findings with rest-redistribution 201Tl imaging and dobutamine echocardiography.
Delayed MRI contrast enhancement patterns were examined from 3 to 15 minutes after injection of 0.1 mmol/kg IV gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Comparable MRI and 201Tl basal and midventricular short-axis images were subdivided into 6 segments. Segments judged nonviable by quantitative and qualitative assessment of 201Tl scans showed persistent, systematically greater MRI contrast signal intensity than segments judged viable (P</=0.002). Delayed contrast hyperenhancement also occurred in segments judged nonviable by dobutamine echocardiography (P</=0.03). The presence or absence of hyperenhancement correlated most closely with nonviability and viability, respectively, in segments that were akinetic or dyskinetic under resting conditions (83% concordance with 201Tl in both cases). In segments with resting hypokinesis, 58% of segments showing hyperenhancement were judged viable by 201Tl and may have represented an admixture of scar tissue and viable myocardium.
Delayed (by 3 to 15 minutes) hyperenhancement of Gd-DTPA contrast-enhanced MRI images occurs frequently in dysfunctional areas of the left ventricle in patients with stable CAD. Hyperenhancement is associated with nonviability by rest-redistribution 201Tl scintigraphy and dobutamine echocardiography, particularly in regions exhibiting resting akinesis/dyskinesis. The absence of hyperenhancement correlates with radionuclide and echocardiographic determinations of viability, regardless of resting contractile function.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - diagnostic imaging</subject><subject>Cardiovascular system</subject><subject>Contrast Media</subject><subject>Coronary Disease - diagnosis</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Dobutamine</subject><subject>Female</subject><subject>Gadolinium DTPA</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Contraction - physiology</subject><subject>Polylysine</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Thallium Radioisotopes</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ultrasonography</subject><subject>Ventricular Dysfunction, Left - diagnosis</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkd2KFDEQhYMo67j6AF4IQcS7bvPT6U5fyuDPwoIgeh3SSfVulp5kTKV36ZfxWc2wg4JXRdX5ziHkEPKas5bznn9gvN1ffW9H3YquFb0enpAdV6JrOiXHp2THGBubQQrxnLxAvKtrLwd1QS5Grfiouh35vU-xZIuFHuxNhBIczYAp2uiAhnoL8YaGSMstUIsIiAeIhaaZHrbkbPbBLvQ-2CksoWwn8mhLqAjSh1BuKRY7LUBdyjUzb9TmAnX4gGCxRkZPF5gLva-WHNy62Ez9hvMaXQkpviTPZrsgvDrPS_Lz86cf-6_N9bcvV_uP143r5FAaL2Y2gp9g5LNWsxTaeq8kU8p33knLe9BQRaEHqQfttfOgBuWYsKN1_SQvyfvH3GNOv1bAYg4BHSyLjZBWNAPjXEs2VvDtf-BdWnOsbzOCi75nQukK8UfI5YSYYTbHXP8yb4YzcyrOMG5qcWbURnTmVFz1vDkHr9MB_F_HuamqvzvrFp1d5lwbCvgvuOeDEkr-AZfbpRk</recordid><startdate>19981215</startdate><enddate>19981215</enddate><creator>RAMANI, K</creator><creator>JUDD, R. M</creator><creator>HOLLY, T. A</creator><creator>PARRISH, T. B</creator><creator>RIGOLIN, V. H</creator><creator>PARKER, M. A</creator><creator>CALLAHAN, C</creator><creator>FITZGERALD, S. W</creator><creator>BONOW, R. O</creator><creator>KLOCKE, F. J</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19981215</creationdate><title>Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction</title><author>RAMANI, K ; JUDD, R. M ; HOLLY, T. A ; PARRISH, T. B ; RIGOLIN, V. H ; PARKER, M. A ; CALLAHAN, C ; FITZGERALD, S. W ; BONOW, R. O ; KLOCKE, F. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-d2f09edbe91f85f328add53055d4dc3a16e8ee912873878d8cde575c02a9ac6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - diagnostic imaging</topic><topic>Cardiovascular system</topic><topic>Contrast Media</topic><topic>Coronary Disease - diagnosis</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Dobutamine</topic><topic>Female</topic><topic>Gadolinium DTPA</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Contraction - physiology</topic><topic>Polylysine</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Thallium Radioisotopes</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Ultrasonography</topic><topic>Ventricular Dysfunction, Left - diagnosis</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>RAMANI, K</creatorcontrib><creatorcontrib>JUDD, R. M</creatorcontrib><creatorcontrib>HOLLY, T. A</creatorcontrib><creatorcontrib>PARRISH, T. B</creatorcontrib><creatorcontrib>RIGOLIN, V. H</creatorcontrib><creatorcontrib>PARKER, M. A</creatorcontrib><creatorcontrib>CALLAHAN, C</creatorcontrib><creatorcontrib>FITZGERALD, S. W</creatorcontrib><creatorcontrib>BONOW, R. O</creatorcontrib><creatorcontrib>KLOCKE, F. J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>RAMANI, K</au><au>JUDD, R. M</au><au>HOLLY, T. A</au><au>PARRISH, T. B</au><au>RIGOLIN, V. H</au><au>PARKER, M. A</au><au>CALLAHAN, C</au><au>FITZGERALD, S. W</au><au>BONOW, R. O</au><au>KLOCKE, F. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1998-12-15</date><risdate>1998</risdate><volume>98</volume><issue>24</issue><spage>2687</spage><epage>2694</epage><pages>2687-2694</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>The utility of contrast MRI for assessing myocardial viability in stable coronary artery disease (CAD) with left ventricular dysfunction is uncertain. We therefore performed cine and contrast MRI in 24 stable patients with CAD and regional contractile abnormalities and compared MRI findings with rest-redistribution 201Tl imaging and dobutamine echocardiography.
Delayed MRI contrast enhancement patterns were examined from 3 to 15 minutes after injection of 0.1 mmol/kg IV gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Comparable MRI and 201Tl basal and midventricular short-axis images were subdivided into 6 segments. Segments judged nonviable by quantitative and qualitative assessment of 201Tl scans showed persistent, systematically greater MRI contrast signal intensity than segments judged viable (P</=0.002). Delayed contrast hyperenhancement also occurred in segments judged nonviable by dobutamine echocardiography (P</=0.03). The presence or absence of hyperenhancement correlated most closely with nonviability and viability, respectively, in segments that were akinetic or dyskinetic under resting conditions (83% concordance with 201Tl in both cases). In segments with resting hypokinesis, 58% of segments showing hyperenhancement were judged viable by 201Tl and may have represented an admixture of scar tissue and viable myocardium.
Delayed (by 3 to 15 minutes) hyperenhancement of Gd-DTPA contrast-enhanced MRI images occurs frequently in dysfunctional areas of the left ventricle in patients with stable CAD. Hyperenhancement is associated with nonviability by rest-redistribution 201Tl scintigraphy and dobutamine echocardiography, particularly in regions exhibiting resting akinesis/dyskinesis. The absence of hyperenhancement correlates with radionuclide and echocardiographic determinations of viability, regardless of resting contractile function.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>9851954</pmid><doi>10.1161/01.CIR.98.24.2687</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adult Aged Biological and medical sciences Cardiomyopathies - diagnosis Cardiomyopathies - diagnostic imaging Cardiovascular system Contrast Media Coronary Disease - diagnosis Coronary Disease - diagnostic imaging Dobutamine Female Gadolinium DTPA Humans Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Myocardial Contraction - physiology Polylysine Radiodiagnosis. Nmr imagery. Nmr spectrometry Thallium Radioisotopes Tomography, Emission-Computed, Single-Photon Ultrasonography Ventricular Dysfunction, Left - diagnosis Ventricular Dysfunction, Left - diagnostic imaging |
| title | Contrast magnetic resonance imaging in the assessment of myocardial viability in patients with stable coronary artery disease and left ventricular dysfunction |
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