Objectives: Dipyridamole stress cardiac magnetic resonance (CMR) evaluates the key phases (perfusion and wall motion) of the ischemic cascade. We sought to determine the prognostic value of dipyridamole stress-CMR in consecutive patients symptomatic for chest pain. Methods: Seven hundred and ninety-three consecutive patients symptomatic for chest pain underwent dipyridamole stress-CMR and were followed up for 810 ± 665 days. Patients were classified in group 1 (no- reversible ischemia), group 2 (stress perfusion defect alone), and group 3 [stress perfusion defect plus abnormal wall motion (AWM)]. End points were "all cardiac events" (myocardial infarction, cardiac death and revascularization) and "hard cardiac events" (all cardiac events excluding revascularization). Results: One hundred and ninety-five (24 %) all cardiac events and 53 (7 %) hard cardiac events were observed. All and hard cardiac event rates in groups 1, 2, and 3 were 11 %, 49 %, 69 % and 4 %, 8 %, 21 %, respectively, with a higher rate in group 2 vs. group 1 (p<0.01) and group 3 vs. groups 1 and 2 (p<0.01). Multivariate analysis showed the presence of late gadolinium enhancement and stress perfusion defect plus AWM as independent predictors of all and hard cardiac events. Conclusions: Dipyridamole stress-CMR improves prognostic stratification of patients through differentiation between the different components of the ischemic cascade. Key Points: • Dipyridamole stress cardiac magnetic resonance helps to assess coronary artery disease. • Novel technique to study the key phases of myocardial ischemia. • Combined assessment of perfusion and motion defects. • Dipyridamole stress imaging has additional value for predicting cardiac events.

Prognostic value of dipyridamole stress cardiac magnetic resonance in patients with known or suspected coronary artery disease : a mid-term follow-up study / G. Pontone, D. Andreini, E. Bertella, M. Loguercio, M. Guglielmo, A. Baggiano, G.D. Aquaro, S. Mushtaq, S. Salerni, P. Gripari, C. Rossi, C. Segurini, E. Conte, V. Beltrama, M. Giovannardi, F. Veglia, A.I. Guaricci, A.L. Bartorelli, P. Agostoni, M. Pepi, P.G. Masci. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 26:7(2016 Jul), pp. 2155-2165. [10.1007/s00330-015-4064-x]

Prognostic value of dipyridamole stress cardiac magnetic resonance in patients with known or suspected coronary artery disease : a mid-term follow-up study

G. Pontone;D. Andreini;E. Bertella;M. Loguercio;A. Baggiano;S. Mushtaq;P. Gripari;C. Segurini;E. Conte;F. Veglia;A.L. Bartorelli;P. Agostoni;
2016

Abstract

Objectives: Dipyridamole stress cardiac magnetic resonance (CMR) evaluates the key phases (perfusion and wall motion) of the ischemic cascade. We sought to determine the prognostic value of dipyridamole stress-CMR in consecutive patients symptomatic for chest pain. Methods: Seven hundred and ninety-three consecutive patients symptomatic for chest pain underwent dipyridamole stress-CMR and were followed up for 810 ± 665 days. Patients were classified in group 1 (no- reversible ischemia), group 2 (stress perfusion defect alone), and group 3 [stress perfusion defect plus abnormal wall motion (AWM)]. End points were "all cardiac events" (myocardial infarction, cardiac death and revascularization) and "hard cardiac events" (all cardiac events excluding revascularization). Results: One hundred and ninety-five (24 %) all cardiac events and 53 (7 %) hard cardiac events were observed. All and hard cardiac event rates in groups 1, 2, and 3 were 11 %, 49 %, 69 % and 4 %, 8 %, 21 %, respectively, with a higher rate in group 2 vs. group 1 (p<0.01) and group 3 vs. groups 1 and 2 (p<0.01). Multivariate analysis showed the presence of late gadolinium enhancement and stress perfusion defect plus AWM as independent predictors of all and hard cardiac events. Conclusions: Dipyridamole stress-CMR improves prognostic stratification of patients through differentiation between the different components of the ischemic cascade. Key Points: • Dipyridamole stress cardiac magnetic resonance helps to assess coronary artery disease. • Novel technique to study the key phases of myocardial ischemia. • Combined assessment of perfusion and motion defects. • Dipyridamole stress imaging has additional value for predicting cardiac events.
coronary artery disease; magnetic resonance; myocardial ischemia; myocardial perfusion imaging; prognosis; radiology, nuclear medicine and imaging
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
lug-2016
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/466226
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