Author + information
- Afsaneh Haftbaradaran Mohammadi,
- Puja Mehta,
- Melody Zaya,
- Megha Agarwal,
- B. Delia Johnson,
- John Petersen,
- Tara Sedlak,
- Greg Lentz,
- Babak Azarbal,
- Bruce Samuels,
- Chrisandra Shufelt,
- Piotr Slomka,
- Daniel Berman,
- Carl Pepine,
- C. Noel Bairey Merz and
- Louise Thomson
Women with signs/symptoms of ischemia and no obstructive coronary artery disease (CAD) often have microvascular coronary dysfunction (MCD) but the diagnosis currently requires invasive coronary reactivity testing (CRT). Noninvasive cardiac magnetic resonance imaging (CMRI) can assess myocardial perfusion reserve index (MPRI), but the diagnostic utility for MCD is unknown.
Women (n=138) with signs and symptoms of ischemia and no obstructive CAD (<50% stenosis) had CMRI and CRT. Asymptomatic women (controls, n=21) with normal exercise stress tests had CMRI. MPRI was calculated as ratio stress/rest upslope (Pie Medical). CRT was performed and analyzed as previously published.
The case and control subjects were 55±11 vs 54±9 years, with a mean body mass index 30±8 vs 25±4, p<0.001, respectively. The case subjects included 7% smoker, 10% diabetic, 20% dyslipidemic, and 40% hypertensive. Overall, 128 (80%) of the WISE subjects had an abnormal CRT. The mean MPRI was lower in cases vs controls (1.8±0.5 vs 2.2±0.4, p=0.0003, respectively). The MPRI predicted CRT: area under receiver operator curve = 0.7077, 95% Cl 0.61, 0.81, p=0.0006 (Figure). A threshold MPRI ≤1.9 predicted CRT with sensitivity 65% and specificity 68%.
In women with signs/symptoms of ischemia and no obstructive CAD, noninvasive MPRI is moderately diagnostic of invasively measured MCD. Further work to improve CMRI diagnostic utility using anatomical and ventricular function variables is needed.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: MRI I Prognostic Value of CMR
Abstract Category: 19. Imaging: MRI
Presentation Number: 1137-321
- 2013 American College of Cardiology Foundation