None listed
Conditions
Brief summary
The aims of this study are to assess the reproducibility of perfusion cardiac magnetic resonance (CMR)imaging in patients with symptomatic multivessel coronary artery disease; to compare the reproducibility of this technique in patients with coronary artery disease versus those at low risk of coronary artery disease. Myocardial perfusion assessment in coronary artery disease (CAD) forms the cornerstone of optimal patient management, providing non-invasive diagnostic information integral to the evaluation of new therapies and interventions as well as valuable prognostic information. Cardiac magnetic resonance (CMR) imaging is increasingly being favoured for the assessment of CAD. Despite the appeal and anticipated future application of perfusion CMR, the reproducibility of this technique is yet to be established. Reproducibility is a measure of the ability of a test to produce the same result when applied under similar conditions and thus affects the diagnostic value of the test and impacts upon its clinical and research utility.
Interventions
First pass perfusion cardiac magnetic resonance imaging (CMR) to be performed in 2 groups of particpants: (1) Coronary artery disease group (2) Healthy Volunteer Control group.
Each subject will undergo two CMR examinations performed on two separate occasions up to two weeks apart. CMR
examinations will be performed on a 1.5 Tesla scanner under the supervision of a physician and noninvasive cardiac
monitoring. Subjects will be prepared with two peripheral intravenous cannulae. Each examination
First pass perfusion cardiac magnetic resonance imaging (CMR) to be performed in 2 groups of particpants: (1) Coronary artery disease group (2) Healthy Volunteer Control group. Each subject will undergo two CMR examinations performed on two separate occasions up to two weeks apart. CMR examinations will be performed on a 1.5 Tesla scanner under the supervision of a physician and noninvasive cardiac monitoring. Subjects will be prepared with two peripheral intravenous cannulae. Each examination will involve assessment of resting ventricular function, first-pass myocardial perfusion and and delayed enhancement imaging for infarct diagnosis. First-pass perfusion data and delayed enhancement will be acquired using 0.05mmol/kg (5ml/sec infusion rate) of Gd-DTPA, with images obtained in the three standard short axis planes. Pharmacologic stress will be induced with adenosine administered as an intravenous infusion (0.14mg/kg/min), commenced up to four minutes prior to the commencement of the acquisition. To ensure maximal vasodilatory response to adenosine, all caffeinated beverages will be withheld for 24 hours prior. Myocardial perfusion analysis will be performed on a Phillips EasyVision Platform. Images will be assessed qualitatively and semiquantitatively.
Sponsors
St Vincent's Hospital
Study design
Allocation
Non-randomised trial
Primary purpose
Diagnosis
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
A. Coronary artery disease subgroup 1. Established multivessel coronary artery disease on angiography 2. Canadian cardiovascular society class II-IV angina B. Healthy volunteer subgroup 1. Low risk for coronary artery disease based on a Framingham estimated 10 year coronary heart disease risk of <10% 2. Male or female, age >50years
Exclusion criteria
1. Patients in whom cardiac medical or surgical interventions are likely to occur during the intervening period between the 2 CMR examinations 2. Patients with MR incompatible implants eg. permanent pacemaker 3. Severe claustrophobia 4. Contraindications to adenosine 5. Chronic Atrial fibrillation 6. Unstable angina or myocardial infarction within 7 days 7. Patients with significant renal impairment (glomerular filtration rate <60mL/min
Outcome results
None listed