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J Am Coll Cardiol. 2007 Sep 18;50(12):1174-9. Epub 2007 Sep 4.

Prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging in patients with known or suspected coronary artery disease.

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  • 1Cardiology Department, University Clinic Hospital, University of Valencia, Valencia, Spain. vicentbodi@hotmail.com

Abstract

OBJECTIVES:

We evaluated the prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging (CMR) in patients with chest pain and known or suspected coronary artery disease.

BACKGROUND:

Stress perfusion CMR has been incorporated in daily practice. Data on its prognostic value are preliminary.

METHODS:

Dipyridamole stress CMR was performed in 420 patients with chest pain and known or suspected coronary artery disease. The extent (number of segments according to the 17-segment model) of abnormal wall motion at rest (AWM-rest), abnormal wall motion with dipyridamole (AWM-D), perfusion deficit (at stress first-pass perfusion imaging), and delayed enhancement (at late enhancement imaging) were analyzed.

RESULTS:

During a median follow-up of 420 days, 41 major adverse cardiac events (MACE), including 9 cardiac deaths, 14 nonfatal myocardial infarctions, and 18 readmissions for unstable angina with documented abnormal angiography, were documented. The MACE were more frequent in patients with significant (>1 segment) AWM-rest (22% vs. 5%), AWM-D (21% vs. 4%), perfusion deficit (17% vs. 5%), and delayed enhancement (20% vs. 6%; p <0.0001 in all cases). In a multivariate analysis adjusted for baseline characteristics, the extent of AWM-D was independently related to MACE (hazard ratio [HR] 1.15 [95% confidence interval (CI) 1.06 to 1.24] per segment; p = 0.0006) and to major events (cardiac death or nonfatal myocardial infarction; HR 1.15 [95% CI 1.05 to 1.26] per segment; p = 0.002).

CONCLUSIONS:

Dipyridamole stress CMR is useful for predicting the outcome of patients with known or suspected coronary artery disease.

PMID:
17868810
[PubMed - indexed for MEDLINE]
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