Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025
Free-breathing, non-contrast, three-dimensional whole-heart coronary magnetic resonance imaging for the identification of culprit and vulnerable atherosclerotic plaque.
СтатьяВалидационное исследованиеПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Hajhosseiny Reza, Hartley Adam, Cole Graham, Munoz Camilla, Sethi Amarjit, Al-Lamee Rasha, Khawaja Saud, Zaman Sameer, Howard James, Gopalan Deepa, Ariff Ben, Kaprielian Raffi, Neji Radhouene, Kunze Karl P, Kaura Amit, Prieto Claudia, Khamis Ramzi, Botnar René M
Аннотация
BACKGROUND: Detection of vulnerable coronary plaque can predict future myocardial infarctions. We have developed a novel, non-contrast cardiovascular magnetic resonance sequence (iT2prep-BOOST), enabling simultaneous, co-registered coronary angiography and plaque detection.
OBJECTIVES: To validate iT2prep-BOOST in patients with non-ST-segment elevation myocardial infarction (NSTEMI).
METHODS: 41 patients with suspected NSTEMI were recruited. Invasive coronary angiography ± intravascular imaging was used to classify coronary segments into the following categories: normal, non-culprit and culprit segments; stenosed segments as well as segments with vulnerable plaque features (lipid, calcium, fibroatheroma, thin cap fibroatheroma (TCFA), plaque-rupture and thrombus). The plaque/myocardial signal intensity ratio (PMR) in each coronary segment was analyzed on iT2prep-BOOST.
RESULTS: The mean ± standard deviation PMR of culprit segments was significantly higher than non-culprit segments and normal segments (1.01±0.14 vs. 0.67±0.18 vs. 0.35±0.24, P<0.001, respectively). Coronary segments with lipid, calcium, and fibroatheroma had a significantly higher PMR compared to normal coronary segments (P<0.001), but significantly lower than segments with plaque-rupture and intraluminal thrombus (P<0.05). There was a progressive increase in PMR with increasing coronary segment stenosis (P<0.001). There was a significant association on multivariable analysis between HbA1c as well as family history of coronary artery disease and mean PMR (P=0.05 and P=0.04, respectively).
CONCLUSION: iT2prep-BOOST has the potential to simultaneously visualize coronary artery lumen and plaque and differentiate normal segments from non-culprit and culprit plaque segments non-invasively and without contrast. The prognostic value of PMR needs to be investigated in a prospective multicenter study.
OBJECTIVES: To validate iT2prep-BOOST in patients with non-ST-segment elevation myocardial infarction (NSTEMI).
METHODS: 41 patients with suspected NSTEMI were recruited. Invasive coronary angiography ± intravascular imaging was used to classify coronary segments into the following categories: normal, non-culprit and culprit segments; stenosed segments as well as segments with vulnerable plaque features (lipid, calcium, fibroatheroma, thin cap fibroatheroma (TCFA), plaque-rupture and thrombus). The plaque/myocardial signal intensity ratio (PMR) in each coronary segment was analyzed on iT2prep-BOOST.
RESULTS: The mean ± standard deviation PMR of culprit segments was significantly higher than non-culprit segments and normal segments (1.01±0.14 vs. 0.67±0.18 vs. 0.35±0.24, P<0.001, respectively). Coronary segments with lipid, calcium, and fibroatheroma had a significantly higher PMR compared to normal coronary segments (P<0.001), but significantly lower than segments with plaque-rupture and intraluminal thrombus (P<0.05). There was a progressive increase in PMR with increasing coronary segment stenosis (P<0.001). There was a significant association on multivariable analysis between HbA1c as well as family history of coronary artery disease and mean PMR (P=0.05 and P=0.04, respectively).
CONCLUSION: iT2prep-BOOST has the potential to simultaneously visualize coronary artery lumen and plaque and differentiate normal segments from non-culprit and culprit plaque segments non-invasively and without contrast. The prognostic value of PMR needs to be investigated in a prospective multicenter study.
Предметные рубрики MeSH
HumansPlaque, AtheroscleroticPredictive Value of TestsFemaleMaleMiddle AgedCoronary Artery DiseaseAgedCoronary VesselsCoronary AngiographyReproducibility of ResultsImaging, Three-DimensionalNon-ST Elevated Myocardial InfarctionCoronary StenosisRespirationRupture, SpontaneousImage Interpretation, Computer-AssistedMagnetic Resonance Imaging, Cine