ArticleJACC. Cardiovascular imaging2020
Prognostic Value of Stress CMR Perfusion Imaging in Patients With Reduced Left Ventricular Function.
Article in JACC. Cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03192891 (Stress CMR Perfusion Imaging in the United States), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Stress CMR Perfusion Imaging in the United States (SPINS) Study. A Society for Cardiovascular Magnetic Resonance (SCMR) Registry Study
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Prognostic Value of Stress Perfusion Cardiac MRI in Cardiovascular Disease: A Systematic Review and Meta-Analysis of the Effects of the Scanner, Stress Agent, and Analysis Technique.Radiology. Cardiothoracic imaging · 2024Pooled it
- Article
- State-of-the-art management of ischemic cardiomyopathy: integrating diagnostic pathways, revascularization strategies, and guideline-directed therapy.Heart failure reviews · 2026Review
- Beyond Stenosis: Mechanism-Based Multimodality Imaging and Invasive Coronary Function Testing for Endotype Definition in ANOCA/INOCA.Medicina (Kaunas, Lithuania) · 2026Review
- The Contemporary Role of Cardiovascular Magnetic Resonance in Ischemic Cardiomyopathy.Journal of clinical medicine · 2025Review
- Diagnostic accuracy of late gadolinium enhancement cardiac MRI for coronary artery disease in patients with reduced left ventricular ejection fraction.Heart (British Cardiac Society) · 2025Article
- Article
- A clinician's guide to cardiovascular MRI referrals: a practical guide of ESC recommendations.Future cardiology · 2025Review
- Comparison of machine learning-based CT fractional flow reserve with cardiac MR perfusion mapping for ischemia diagnosis in stable coronary artery disease.European radiology · 2024Article
- Myocardial Late Gadolinium Enhancement (LGE) in Cardiac Magnetic Resonance Imaging (CMR)-An Important Risk Marker for Cardiac Disease.Journal of cardiovascular development and disease · 2024Review
- Cardiac Magnetic Resonance Imaging in Heart Failure.Cardiovascular innovations and applications · 2024Article
- The Society for Cardiovascular Magnetic Resonance Registry at 150,000.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Article
- Value of cardiac magnetic resonance on the risk stratification of cardiomyopathies.World journal of cardiology · 2023Review
- Stress Cardiovascular Magnetic Resonance Imaging for the Detection of Coronary Artery Disease.Reviews in cardiovascular medicine · 2023Review
- Incremental effect of coronary obstruction on myocardial microvascular dysfunction in type 2 diabetes mellitus patients evaluated by first-pass perfusion CMR study.Cardiovascular diabetology · 2023Article
- Heart Failure and Cardiomyopathies: CT and MR from Basics to Advanced Imaging.Diagnostics (Basel, Switzerland) · 2022Review
- Relation of Myocardial Perfusion Reserve and Left Ventricular Ejection Fraction in Ischemic and Nonischemic Cardiomyopathy.The American journal of cardiology · 2022Article
- Stress Perfusion Cardiac Magnetic Resonance in Long-Standing Non-Infarcted Chronic Coronary Syndrome with Preserved Systolic Function.Diagnostics (Basel, Switzerland) · 2022Article
- Stress Cardiac Magnetic Resonance Myocardial Perfusion Imaging: JACC Review Topic of the Week.Journal of the American College of Cardiology · 2021Review
- Evidence and Applicability of Stress Cardiovascular Magnetic Resonance in Detecting Coronary Artery Disease: State of the Art.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
23 authors at 16 institutions in 3 countries.
Funding
Abstract
objectivesThe aim of this study was to investigate the prognostic value of stress cardiac magnetic resonance imaging (CMR) in patients with reduced left ventricular (LV) systolic function.
backgroundPatients with ischemic cardiomyopathy are at risk from both myocardial ischemia and heart failure. Invasive testing is often used as the first-line investigation, and there is limited evidence as to whether stress testing can effectively provide risk stratification.
methodsIn this substudy of a multicenter registry from 13 U.S. centers, patients with reduced LV ejection fraction (<50%), referred for stress CMR for suspected myocardial ischemia, were included. The primary outcome was cardiovascular death or nonfatal myocardial infarction. The secondary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, hospitalization for unstable angina or congestive heart failure, and unplanned late coronary artery bypass graft surgery.
resultsAmong 582 patients (mean age 62 ± 12 years, 34% women), 40% had a history of congestive heart failure, and the median LV ejection fraction was 39% (interquartile range: 28% to 45%). At median follow-up of 5.0 years, 97 patients had experienced the primary outcome, and 182 patients had experienced the secondary outcome. Patients with no CMR evidence of ischemia or late gadolinium enhancement (LGE) experienced an annual primary outcome event rate of 1.1%. The presence of ischemia, LGE, or both was associated with higher event rates. In a multivariate model adjusted for clinical covariates, ischemia and LGE were independent predictors of the primary (hazard ratio [HR]: 2.63; 95% confidence interval [CI]: 1.68 to 4.14; p < 0.001; and HR: 1.86; 95% CI: 1.05 to 3.29; p = 0.03) and secondary (HR: 2.14; 95% CI: 1.55 to 2.95; p < 0.001; and HR 1.70; 95% CI: 1.16 to 2.49; p = 0.007) outcomes. The addition of ischemia and LGE led to improved model discrimination for the primary outcome (change in C statistic from 0.715 to 0.765; p = 0.02). The presence and extent of ischemia were associated with higher rates of use of downstream coronary angiography, revascularization, and cost of care spent on ischemia testing.
conclusionsStress CMR was effective in risk-stratifying patients with reduced LV ejection fractions. (Stress CMR Perfusion Imaging in the United States [SPINS] Study; NCT03192891).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.