ArticleCirculation. Cardiovascular imaging2023
Comparison of Stress-Rest and Stress-LGE Analysis Strategy in Patients Undergoing Stress Perfusion Cardiovascular Magnetic Resonance.
Article in Circulation. Cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Accelerated stress CMR for the detection of significant coronary artery disease: a prospective randomized diagnostic accuracy study.European heart journal. Cardiovascular Imaging · 2026Trial
- Myocardial Viability and Ischaemia in Chronic Total Occlusion.Medicina (Kaunas, Lithuania) · 2026Article
- Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Impactful Cardiac CT and MRI Articles from 2023.Radiology. Cardiothoracic imaging · 2024Review
- Cardiovascular imaging research and innovation in 2023.European heart journal. Imaging methods and practice · 2024Review
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5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStress perfusion cardiovascular magnetic resonance can be performed without rest perfusion for the quantification of ischemia burden. However, the optimal method of analysis is uncertain.
methodsWe identified 666 patients from CE-MARC (Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease) with complete stress perfusion, rest perfusion, late gadolinium enhancement (LGE), and quantitative coronary angiography data. For each segment of the 16-segment model, perfusion was visually graded during stress and rest imaging, with infarct transmurality assessed from LGE imaging. In the stress-LGE analysis, a segment was defined as ischemic if it had a subendocardial perfusion defect with no infarction. Rest perfusion was not used in this analysis. We compared the diagnostic accuracy of stress-LGE analysis against quantitative coronary angiography and the stress-rest method validated in the original CE-MARC analysis. The diagnostic accuracy of the stress-LGE method was evaluated with different thresholds of infarct transmurality used to define whether an infarcted segment had peri-infarct ischemia.
resultsThe optimal stress-LGE analysis classified all segments with a stress perfusion defect as ischemic unless they had >75% infarct transmurality (area under the curve, 0.843; sensitivity, 75.6%; specificity, 93.1%;
conclusionsIn this analysis of CE-MARC, the optimum definition of inducible ischemia was the presence of a stress-induced perfusion defect without transmural infarction. This definition improved the diagnostic accuracy compared with the stress-rest analysis validated in the original study. The absence of ischemia by either analysis strategy conferred a favorable long-term prognosis.
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