Evidence map›Paper›PMID 41619975›Full record

ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance

Stress T1 mapping for the detection of obstructive coronary artery disease: a prospective diagnostic accuracy study.

Simran Shergill, Mohamed Elshibly, Anju Velvet, Aida Moafi, Rachel England, Kelly S Parke, Joanne V Wormleighton, David Adlam, Sandeep S Hothi, Peter Kellman and 5 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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.

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, Leicester, UK.
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, Leicester, UK.
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, Leicester, 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, Leicester, 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, 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, Leicester, UK.
Joanne V WormleightonDepartment 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, Leicester, 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, Leicester, UK.
Sandeep S HothiHeart and Lung Centre, Royal Wolverhampton NHS Trust, Wolverhampton, UK; Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
Peter KellmanNational Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
Alasdair McIntoshRobertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Alex McConnachieRobertson Centre for Biostatistics, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
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, Leicester, UK; Department of Cardiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
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, Leicester, 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, Leicester, UK. Electronic address: jra14@leicester.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the assessment of patients with suspected coronary artery disease (CAD), the diagnostic role of stress-perfusion cardiovascular magnetic resonance (CMR) is well established. However, its reliance on gadolinium-based contrast agents may restrict its application in certain populations. T1 mapping during vasodilatory stress has been proposed as a contrast-free alternative for detecting CAD. This study sought to compare the diagnostic accuracy of adenosine-stress T1 reactivity (ΔT1) with that of stress-perfusion CMR for identifying hemodynamically significant CAD.

methodsPatients with suspected angina referred for diagnostic invasive coronary angiography underwent 3-Tesla CMR consisting of the following: (1) T1 mapping at rest and following intravenous adenosine using a modified Look-Locker inversion recovery sequence, (2) stress and rest perfusion, and (3) late-gadolinium enhancement. Significant CAD was defined invasively as fractional flow reserve ≤0.80 in epicardial vessels ≥2 mm diameter (or quantitative flow ratio ≤0.80 if unavailable). A ΔT1 vessel threshold (% increase in T1 from rest to stress) was derived from receiver operating characteristic analysis, using invasive coronary angiography as the reference standard. Stress-perfusion CMR was assessed qualitatively with CAD determined by the presence of ischemia and/or infarction, (A) per-vessel (as determined by two independent readers) and (B) per-patient (following consensus read).

resultsOf 121 prospectively recruited patients, 115 had paired T1 mapping and coronary angiography data (mean age 66 ± 9 years, 72% [83/115] male, CAD prevalence 51% [59/115]). ΔT1 demonstrated poor diagnostic performance for detecting significant CAD (area under the curve 0.59 [95% CI: 0.52, 0.65], p = 0.011), with an optimal vessel threshold ≤4.36% giving accuracy 54.9%, sensitivity 68.3%, and specificity 49.2%. Stress-perfusion CMR demonstrated superior diagnostic accuracy compared to ΔT1: (A) per-vessel (for the two independent reads, +26.2% [19.4%, 32.6%] and +26.7% [19.9%, 33.3%], both p<0.001) and (B) per-patient (for consensus read, +21.7% [10.2%, 32.6%], p<0.001).

conclusionIn patients with suspected angina, ΔT1 demonstrates limited diagnostic accuracy for the detection of obstructive CAD. Future efforts should be directed toward alternative contrast-free methods for the reliable detection of CAD in this population.

Indexed as

AdenosineCoronary Artery DiseaseCoronary StenosisCoronary VesselsMyocardial Perfusion ImagingVasodilator AgentsAgedArea Under CurveContrast MediaCoronary AngiographyFemaleFractional Flow Reserve, MyocardialHumansMaleMiddle AgedOrganometallic CompoundsAdenosineContrast MediaOrganometallic CompoundsVasodilator AgentsContrast-freeFractional flow reserveMOLLI T1 mappingMyocardial ischemiaStress-perfusion CMR

Identifiers

PMID41619975
PMCPMC13237545

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Registered trials

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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.