Evidence map›Paper›PMID 41264815›Full record

Trial reportEuropean heart journal. Cardiovascular Imaging2026

Accelerated stress CMR for the detection of significant coronary artery disease: a prospective randomized diagnostic accuracy study.

Mohamed Elshibly, Simran Shergill, Anju Velvet, Aisha Gohar, Shreyansh Pattani, Kelly S Parke, Rachel England, Aida Moafi, George Hudson, Jeffrey Khoo and 9 more

Abstract readRandomized Controlled TrialComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal. Cardiovascular Imaging, 2026. 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. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Mohamed ElshiblyDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.ORCID 0000-0001-8555-5141
Simran ShergillDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.ORCID 0000-0003-4761-7297
Anju VelvetDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Aisha GoharDepartment of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Shreyansh PattaniDepartment of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Kelly S ParkeDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Rachel EnglandDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Aida MoafiDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
George HudsonDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Jeffrey KhooDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Declan P O'ReganMedical Research Council Laboratory of Medical Sciences, Imperial College London, London, UK.
Olivia WuHealth Economics and Health Technology Assessment, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
David AdlamDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
Peter KellmanDepartment of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.ORCID 0000-0002-9875-6070
Alasdair McIntoshSchool of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.ORCID 0000-0003-2534-8647
Alex McConnachieSchool of Health and Wellbeing, Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7262-7000
Andrew LadwiniecDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.ORCID 0000-0002-1551-0594
Gerry P McCannDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.
J Ranjit ArnoldDepartment of Cardiovascular Sciences, University of Leicester, The National Institute for Health and Care Research Leicester Biomedical Research Centre and British Heart Foundation Centre of Research Excellence, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, UK.

Funding

British Heart Foundation CH/P/23/80008British Heart Foundation RE/24/130023British Heart Foundation RG/F/24/110138Medical Research Council MC_UP_1605/13NIHR RP-2017-08-ST2-007NIHR Clinician Scientist CS-2018-18-ST2-007NIHR Research NIHR201460
6 · The paper itself

Abstract

aimsIn patients with suspected coronary artery disease (CAD), the role of adenosine-stress cardiovascular magnetic resonance (CMR) is well established. However, to meet increasing demand, improving its time efficiency and cost-effectiveness is critical. Recent advances in accelerated, free-breathing cine and scar imaging now enable accelerated stress-perfusion protocols. This study evaluated whether an accelerated, stress-only perfusion protocol achieves non-inferior diagnostic accuracy compared with a standard stress-rest perfusion CMR protocol for detecting significant CAD. METHODS AND

resultsPatients with suspected angina referred for invasive coronary angiography (ICA) underwent two 3-Tesla CMR scans (standard and accelerated protocols), on separate days in randomized order. Significant CAD was defined as fractional flow reserve (FFR) ≤ 0.80 in epicardial vessels ≥2 mm diameter (or quantitative flow ratio ≤0.80 if FFR unavailable). CMR images were evaluated qualitatively with (i) primary per-vessel analysis (determined by two independent readers) and (ii) secondary per-patient analysis (following consensus read). Of 167 prospectively recruited patients, 150 completed both CMR protocols and ICA (mean age 66 ± 10 years, 71% male, CAD prevalence 51%). The accelerated scan was better tolerated by patients, with scan duration 19 ± 5 min (24 min shorter than the standard protocol [95% CI: 23, 25], P < 0.001). Compared with standard CMR, accelerated CMR achieved non-inferior per-vessel diagnostic accuracy at a pre-specified 5% non-inferiority margin (+0.7% [-2.7%, 4.0%], pnon-inferiority = 0.001 and +3.4% [-0.1%, 6.8%], pnon-inferiority < 0.001 for the two readers). Accelerated CMR also achieved comparable per-patient accuracy (+4.6% [-1.5%, 11.0%], P = 0.189 for consensus read; accuracy 88.6%, sensitivity 84.2%, and specificity 93.2%).

conclusionCompared to standard stress-perfusion CMR, an accelerated stress-perfusion protocol achieves non-inferior diagnostic accuracy at the vessel level, with a time saving of over 20 min per scan. Accelerated imaging may prove effective in the clinical arena to evaluate patients with suspected angina.

Indexed as

Coronary Artery DiseaseMagnetic Resonance Imaging, CineAdenosineAgedCoronary AngiographyExercise TestFemaleFractional Flow Reserve, MyocardialHumansMaleMiddle AgedProspective StudiesReproducibility of ResultsSensitivity and SpecificitySeverity of Illness IndexAdenosineFractional flow reserveMyocardial perfusionRapid protocolsStable anginaStress perfusion cardiovascular magnetic resonance

Identifiers

PMID41264815
PMCPMC13021280

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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.