English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Open

Presents the pdf analysis as premium feature

PDF Analysis

Insights

Presents the summarisation as premium feature

Summarisation

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Background  Recent studies using stress‐rest perfusion cardiovascular magnetic resonance ( CMR ) demonstrated a close correlation between myocardial ischemia and reduced fractional flow reserve ( FFR ). However, its diagnostic concordance may be reduced in patients with multivessel disease. We sought to evaluate the concordance of adenosine stress‐rest perfusion  CMR  for predicting reduced  FFR , and to determine the additive value of measuring global coronary flow reserve ( CFR ) in the coronary sinus in multivessel disease.    Methods and Results  Ninety‐six patients with angiographic luminal narrowing >50% underwent comprehensive  CMR  study and  FFR  measurements in 139 coronary vessels.  FFR  <0.80 was considered hemodynamically significant. Global  CFR  was quantified as the ratio of stress‐rest coronary sinus flow measured by phase‐contrast cine  CMR . In 25 patients with single‐vessel disease, visual assessment of perfusion  CMR  yielded high diagnostic concordance for predicting flow‐limiting stenosis, with the area under receiver operating characteristic curve of 0.93 on a per‐patient basis. However, in 71 patients with multivessel disease, perfusion  CMR  underestimated flow‐limiting stenosis, resulting in the reduced area under receiver operating characteristic curve of 0.74. When  CFR  of <2.0 measured in the coronary sinus was considered as global myocardial ischemia, combined assessment provided correct reclassifications in 7 patients with false‐negative myocardial ischemia, and improved the diagnostic concordance to 92% sensitivity and 73% specificity with the area under receiver operating characteristic curve of 0.88 (95% confidence interval, 0.80%–0.97%,  P =0.002).    Conclusions  Visual analysis of stress‐rest perfusion  CMR  has limited concordance with  FFR  in patients with multivessel disease. Multiparametric  CMR  integrating stress‐rest perfusion  CMR  and flow measurement in the coronary sinus is useful for detecting reduced  FFR  in multivessel disease.

journal of the american heart association

Combined Assessment of Stress Myocardial Perfusion Cardiovascular Magnetic Resonance and Flow Measurement in the Coronary Sinus Improves Prediction of Functionally Significant Coronary Stenosis Determined by Fractional Flow Reserve in Multivessel Disease