Evidence map›Paper›PMID 37581660›Full record

ArticleEuropean radiology2024

Value of a short non-contrast CMR protocol in MINOCA.

Marco Gatti, Anna Palmisano, Mattia Gerboni, Riccardo Cau, Alessandra Pintus, Michele Porcu, Davide Tore, Davide Vignale, Alessandro Andreis, Laura Bergamasco and 5 more

Abstract read
In one paragraph

Article in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Marco GattiRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy. m.gatti@unito.it.ORCID http://orcid.org/0000-0001-8168-5280
Anna PalmisanoClinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Mattia GerboniRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
Riccardo CauDepartment of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy.
Alessandra PintusDepartment of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy.
Michele PorcuDepartment of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy.
Davide ToreRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
Davide VignaleClinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Alessandro AndreisDivision of Cardiology, Department Cardiovascular and Thoracic, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy.
Laura BergamascoRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
Gaetano Maria De FerrariDivision of Cardiology, Department Cardiovascular and Thoracic, Città Della Salute E Della Scienza Hospital, University of Turin, Turin, Italy.
Antonio EspositoClinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
Luca SabaDepartment of Radiology, AOU Cagliari, University of Cagliari, Cagliari, Italy.
Paolo FonioRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
Riccardo FalettiRadiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the diagnostic performance of a short non-contrast CMR (ShtCMR) protocol relative to a matched standard comprehensive CMR (StdCMR) protocol in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA).

methodsThis multicenter retrospective study included patients with a working diagnosis of MINOCA who underwent a StdCMR between January 2019 and December 2020. An expert and a non-expert reader performed a blinded reading with the ShtCMR (long-axis cine images, T2w-STIR, T1- and T2-mapping). A consensus reading of the StdCMR (reference standard) was performed at least 3 months after the ShtCMR reading session. Readers were asked to report the following: (1) diagnosis; (2) level of confidence in their diagnosis with the ShtCMR; (3) number of myocardial segments involved, and (4) functional parameters.

resultsA total of 179 patients were enrolled. The ShtCMR lasted 21 ± 9 min and the StdCMR 45 ± 11 min (p < 0.0001). ShtCMR allowed reaching the same diagnosis as StdCMR in 85% of patients when interpreted by expert readers (rising from 66% for poor confidence to 99% for good, p = 0.0001) and in 73% (p = 0.01) by non-expert ones (60% for poor vs 89% for good confidence, p = 0.0001). Overall, the ShtCMR overestimated the ejection fraction, underestimated cardiac volumes (p < 0.01), and underestimated the number of segments involved by pathology (p = 0.0008) when compared with the StdCMR.

conclusionThe ShtCMR was found to be a debatable alternative to the StdCMR in patients with MINOCA. Nevertheless, when an experienced reader reaches a good or very good diagnostic confidence using the ShtCMR, the reader may choose to stop the examination, reducing the length of the CMR without affecting the patient's diagnosis. CLINICAL RELEVANCE STATEMENT: A short non-contrast CMR protocol may be a viable alternative to standard protocols in selected CMR studies of patients with MINOCA, allowing for faster diagnosis while reducing time and resources and increasing the number of patients who can be scanned. KEY POINTS: • The ShtCMR lasted 21 ± 9 min and the StdCMR 45 ± 11 min (p < 0.0001). • In 57% of patients with MINOCA, the experienced reader considers that contrast medium is probably not necessary for diagnosis without affecting the patient's diagnosis (99% of agreement rate between ShtCMR and StdCMR).

Indexed as

Myocardial InfarctionMyocarditisHumansMINOCAMulticenter Studies as TopicMyocardiumRetrospective StudiesChest painMINOCAMyocardial infarctionMyocarditisTakotsubo cardiomyopathy

Identifiers

PMID37581660
PMCPMC10853081

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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.