Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing

Background: Cardiac magnetic resonance perfusion imaging during vasodilator stress is an established modality in patients with suspected and known coronary artery disease (CAD).Aim: This study aimed to evaluate the performance of fast-Strain-Encoded-MRI (fast-SENC) for the diagnostic classification...

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Autores principales:	Henning Steen, Moritz Montenbruck, Sebastian Kelle, Sebastian Esch, Arne Kristian Schwarz, Sorin Giusca, Grigorios Korosoglou
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	fast strain-encoded CMR (fast-SENC) average perfusion score index adenosine late gadolinium enhancement cardiac outcomes Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f61f08f37d104b30844d64c3378dd603
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spelling	oai:doaj.org-article:f61f08f37d104b30844d64c3378dd6032021-11-17T05:22:50ZFast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing2297-055X10.3389/fcvm.2021.765961https://doaj.org/article/f61f08f37d104b30844d64c3378dd6032021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.765961/fullhttps://doaj.org/toc/2297-055XBackground: Cardiac magnetic resonance perfusion imaging during vasodilator stress is an established modality in patients with suspected and known coronary artery disease (CAD).Aim: This study aimed to evaluate the performance of fast-Strain-Encoded-MRI (fast-SENC) for the diagnostic classification and risk stratification of patients with ischemic heart disease.Methods: Perfusion and fast-SENC cardiac magnetic resonance (CMR) images were retrospectively analyzed in 111 patients who underwent stress CMR. The average myocardial perfusion score index, global and segmental longitudinal and circumferential strain (GLS and GCS and SLS and SCS, respectively), were measured at rest and during stress. The combination of SLS and SCS was referred to as segmental aggregate strain (SAS). Segments exhibiting perfusion defects or SAS impairment during stress were defined as “ischemic.” All-cause mortality, non-fatal infarction, and urgent revascularization were deemed as our combined clinical endpoint.Results: During adenosine stress testing, 44 of 111 (39.6%) patients exhibited inducible perfusion abnormalities. During a mean follow-up of 1.94 ± 0.65 years, 25 (22.5%) patients reached the combined endpoint (death in n = 2, infarction in n = 3 and urgent revascularization in n = 20). Inducible perfusion defects were associated with higher number of segments with inducible SAS reduction ≥6.5% (χ2 = 37.8, AUC = 0.79, 95% CI = 0.71–0.87, p < 0.001). In addition, patients with inducible perfusion defects or SAS impairment exhibited poorer outcomes (AUCPerf = 0.81 vs. AUCSAS = 0.74, p = NS vs. each other, and χ2 = 30.8, HR = 10.3 and χ2 = 9.5, HR = 3.5, respectively, p < 0.01 for both).Conclusion: Purely quantitative strain analysis by fast-SENC during vasodilator stress was related to the diagnosis of ischemia by first-pass perfusion and is non-inferior for the risk stratification of patients with ischemic heart disease. This may bear clinical implications, especially in patients with contraindications for contrast agent administration.Henning SteenMoritz MontenbruckSebastian KelleSebastian KelleSebastian KelleSebastian EschArne Kristian SchwarzSorin GiuscaSorin GiuscaGrigorios KorosoglouGrigorios KorosoglouFrontiers Media S.A.articlefast strain-encoded CMR (fast-SENC)average perfusion score indexadenosinelate gadolinium enhancementcardiac outcomesDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	fast strain-encoded CMR (fast-SENC) average perfusion score index adenosine late gadolinium enhancement cardiac outcomes Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	fast strain-encoded CMR (fast-SENC) average perfusion score index adenosine late gadolinium enhancement cardiac outcomes Diseases of the circulatory (Cardiovascular) system RC666-701 Henning Steen Moritz Montenbruck Sebastian Kelle Sebastian Kelle Sebastian Kelle Sebastian Esch Arne Kristian Schwarz Sorin Giusca Sorin Giusca Grigorios Korosoglou Grigorios Korosoglou Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
description	Background: Cardiac magnetic resonance perfusion imaging during vasodilator stress is an established modality in patients with suspected and known coronary artery disease (CAD).Aim: This study aimed to evaluate the performance of fast-Strain-Encoded-MRI (fast-SENC) for the diagnostic classification and risk stratification of patients with ischemic heart disease.Methods: Perfusion and fast-SENC cardiac magnetic resonance (CMR) images were retrospectively analyzed in 111 patients who underwent stress CMR. The average myocardial perfusion score index, global and segmental longitudinal and circumferential strain (GLS and GCS and SLS and SCS, respectively), were measured at rest and during stress. The combination of SLS and SCS was referred to as segmental aggregate strain (SAS). Segments exhibiting perfusion defects or SAS impairment during stress were defined as “ischemic.” All-cause mortality, non-fatal infarction, and urgent revascularization were deemed as our combined clinical endpoint.Results: During adenosine stress testing, 44 of 111 (39.6%) patients exhibited inducible perfusion abnormalities. During a mean follow-up of 1.94 ± 0.65 years, 25 (22.5%) patients reached the combined endpoint (death in n = 2, infarction in n = 3 and urgent revascularization in n = 20). Inducible perfusion defects were associated with higher number of segments with inducible SAS reduction ≥6.5% (χ2 = 37.8, AUC = 0.79, 95% CI = 0.71–0.87, p < 0.001). In addition, patients with inducible perfusion defects or SAS impairment exhibited poorer outcomes (AUCPerf = 0.81 vs. AUCSAS = 0.74, p = NS vs. each other, and χ2 = 30.8, HR = 10.3 and χ2 = 9.5, HR = 3.5, respectively, p < 0.01 for both).Conclusion: Purely quantitative strain analysis by fast-SENC during vasodilator stress was related to the diagnosis of ischemia by first-pass perfusion and is non-inferior for the risk stratification of patients with ischemic heart disease. This may bear clinical implications, especially in patients with contraindications for contrast agent administration.
format	article
author	Henning Steen Moritz Montenbruck Sebastian Kelle Sebastian Kelle Sebastian Kelle Sebastian Esch Arne Kristian Schwarz Sorin Giusca Sorin Giusca Grigorios Korosoglou Grigorios Korosoglou
author_facet	Henning Steen Moritz Montenbruck Sebastian Kelle Sebastian Kelle Sebastian Kelle Sebastian Esch Arne Kristian Schwarz Sorin Giusca Sorin Giusca Grigorios Korosoglou Grigorios Korosoglou
author_sort	Henning Steen
title	Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
title_short	Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
title_full	Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
title_fullStr	Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
title_full_unstemmed	Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing
title_sort	fast-strain encoded cardiac magnetic resonance during vasodilator perfusion stress testing
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f61f08f37d104b30844d64c3378dd603
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Fast-Strain Encoded Cardiac Magnetic Resonance During Vasodilator Perfusion Stress Testing

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